Abstract
Purpose
Pharmacovigilance Centres (PVCs) provide independent drug information to healthcare professionals in addition to their pharmacovigilance activities. However, their impact on clinical decision-making has been poorly studied. This study assessed the impact of a French PVC on clinical management in a tertiary university hospital (Toulouse University Hospital).
Methods
We conducted a retrospective observational study including all drug-related enquiries submitted to the Toulouse PVC during 2024. Impact was evaluated according to three predefined criteria: whether the enquiry was submitted before or after a clinical management decision had been made, concordance between PVC recommendations and subsequent clinical management, and documentation of the advice in the electronic patient record. Based on these criteria, impact was classified as certain, probable, or uncertain for enquiries submitted before clinical management, and as confirmatory (validating an already implemented decision) or uncertain for enquiries submitted after clinical management had already been initiated.
Results
A total of 128 enquiries were analysed. Most concerned adverse drug reactions (111/128), involved hospitalised patients (100/128), and originated from a broad range of clinical departments, mainly geriatrics (14/128), gastroenterology (11/128), neurology (11/128), infectious diseases (10/128) and internal medicine (10/128). Overall, clinical management was concordant with PVC recommendations in 87% of cases. Among the 92 pre-decision enquiries, PVC impact was classified as certain in 62% and probable in 24% of cases. Among the 36 post-decision enquiries, PVC advice was confirmatory in 44% of cases. The enquiries also generated 50 pharmacovigilance reports, including one potential safety signal.
Conclusion
PVCs support both clinical decision-making and drug safety surveillance.
Keywords: Clinical pharmacology, Pharmacovigilance, Drug information services, Adverse drug reaction
Introduction
In France, the pharmacovigilance network, composed of regional pharmacovigilance centres (PVCs) integrated within university hospitals, constitutes a major component of drug safety surveillance and clinical pharmacology expertise [1]. PVCs are responsible for collecting, analyzing, and evaluating adverse drug reactions as part of the French national pharmacovigilance system [1]. In addition to this core mission, PVCs are staffed by clinical pharmacologists (physicians and pharmacists) who also operate Drug Information Services for healthcare professionals and patients [2, 3]. Drug Information Services routinely provide advices regarding adverse drug reactions, prescribing optimisation (drug interaction, deprescribing, identification of medication potentially inappropriate) and medication use during pregnancy or breastfeeding [2–5]. They support the safe and appropriate use of medicines notably in complex therapeutic situations [6]. They deliver independent and evidence-based information on medicines by critically appraising the scientific literature [2, 7].
Drug Information Services have been evaluated in several countries under different organizational models, including Medicines Information Services, Drug Information Centres and pharmacy-led medicines advice services. Most publish studies reported a positive perceived impact on patient care and medication safety [8–13]. However, most evaluations rely on healthcare professionals’ or patients’ perceptions rather than on objective assessment of impact on clinical decision-making and patient management [8–10]. To our knowledge, no study has specifically evaluated the influence of French Drug Information Centres responses on clinical practice. The aim of this study was therefore to assess the impact of PVC advice on clinical decision-making in a French university hospital.
Methods
Settings
The Toulouse PVC is one of the 30 French Regional PVC and is embedded within the Department of Clinical Pharmacology at Toulouse University Hospital, a tertiary university hospital serving the Occitanie region in southwest France. In addition to its pharmacovigilance mission, this PVC operates an independent Drug Information Service that provides evidence-based advice to healthcare professionals and patients on adverse drug reactions, drug interactions, rational use of medicines, medication use in special populations, and other medication-related questions. The service is staffed by clinical pharmacologists (physicians and pharmacists) with expertise in pharmacovigilance and clinical pharmacology. Enquiries regarding a specific patient are received by telephone or email, and answered through written recommendations based on critical appraisal of the scientific literature and national or international guidelines. The PVC also disseminates independent drug information through the publicly accessible regional pharmacology bulletins [14].
Study design
We conducted a retrospective observational study including all drug-related enquiries submitted by healthcare professionals at Toulouse University Hospital to the Toulouse Regional Pharmacovigilance Centre from Toulouse University Hospital between January 1st and December 31, 2024. The study included both inpatients and outpatients at the Toulouse University Hospital. General drug information requests that could not be linked to an individual patient’s clinical management were excluded from the study. Enquiries were reviewed and classified by type of request (adverse drug reactions, drug interactions, and rational use of medicines). Enquiries related to pregnancy and lactation represent a distinct category of drug information requests involving a highly specific patient population and clinical decision-making process and were excluded from this study.
Data collected
Only patient-specific enquiries concerning an identifiable patient managed at Toulouse University Hospital were included. For each enquiry, the complete electronic patient record was reviewed, including hospital discharge summaries, inpatient medical notes, outpatient consultation letters, and clinical pharmacists’ notes when available. The following information was collected:
hospital department in which the patient was managed;
drugs involved in the request;
the clinical management related to the enquiry (including treatment discontinuation or continuation, dose modification, additional monitoring);
patient follow-up related to the enquiry particularly for outpatient consultations for whom subsequent consultation letters were available in the electronic patient record;
whether the request to the PVC was submitted before or after a clinical management decision had been taken. Enquiries for which this temporal relationship could not be established were excluded from the analysis;
whether the PVC advice was explicitly documented in the electronic patient record.
Finally, the clinical management documented in the electronic patient record was compared with the written PVC recommendation to assess concordance according to the predefined impact classification.
Evaluation of clinical impact
The impact of PVC responses was evaluated as following:
First, we classified whether the PVC was consulted before or after a clinical management decision had been made;
Second, we determine the concordance between the PVC recommendation and the clinical management. Concordance was categorized as follows: (i) recommendation followed; (ii) recommendation not followed with a justified alternative clinical decision; (iii) recommendation not followed. Enquiries with insufficient information to conclude if the recommendation was followed or not were excluded;
Third, we evaluated the documentation of the PVC advice in the electronic patient record.
Based on these criteria, an impact classification was developed. For enquiries submitted before a clinical management decision had been made, PVC impact was classified as certain, probable, or uncertain according to the chronology of the request, the level of concordance between the recommendation and subsequent clinical management, and documentation of the advice in the electronic patient record (Table 1). For enquiries submitted after a clinical management decision had already been made, PVC impact was classified as confirmatory or uncertain (Table 1). In this context, “confirmatory” refers to enquiries where the healthcare team had already implemented a clinical decision, and the PVC subsequently validated this decision as appropriate. Conversely, the “uncertain” category reflects the inability to determine whether the PVC advice had any additional influence on patient management. The impact categories therefore reflected the degree of certainty that PVC advice contributed to clinical management decisions, rather than an assessment of the appropriateness of the clinical management itself.
Table 1.
Algorithm used to classify the impact of Pharmacovigilance Centre (PVC) advice on clinical management according to the timing of the enquiry, concordance with clinical management, and documentation in the electronic patient record
| Chronology of the enquiry | Concordance between PVC recommendation and clinical management | PVC advice documented in the electronic patient record | IMPACT Classification |
|---|---|---|---|
| Before a clinical management decision had been made | Recommendation followed or Recommendation not followed, with a justified alternative clinical decision | Yes | CERTAIN |
| Recommendation followed | No | PROBABLE | |
| Recommendation not followed, with a justified alternative clinical decision | No | UNCERTAIN | |
| Recommendation not followed | Yes | UNCERTAIN | |
| No | UNCERTAIN | ||
| After a clinical management decision had been made | Recommendation followed or Recommendation not followed, with a justified alternative clinical decision | Yes | CONFIRMATORY |
| Recommendation followed | No | UNCERTAIN | |
| Recommendation not followed with a justified alternative clinical decision | No | UNCERTAIN | |
| Recommendation not followed | Yes | UNCERTAIN | |
| No | UNCERTAIN |
PVC: pharmacovigilance centre
The interpretation of the uncertain category depends on the timing of the enquiry. For enquiries submitted before a clinical management decision, uncertain indicates that the influence of PVC advice on the subsequent clinical decision could not be established. For enquiries submitted after a clinical management decision, uncertain indicates that the PVC was consulted after the decision had already been implemented, but there was no documentation allowing attribution of any additional impact of PVC advice
This evaluation grid was developed by consensus based on discussions among all the clinical pharmacologists involved in this paper. This grid was specifically developed for the present study using predefined criteria applicable to retrospective review of electronic patient records.
Recording of adverse drug reactions inquiries into the pharmacovigilance system
As French PVCS are also responsible for collecting adverse drug reactions, we assessed whether each enquiry was followed by recording into the French pharmacovigilance system overseen by the French National Agency for Medicines and Health Products Safety and whether it was considered a potential safety signal [15], that is to say an unexpected serious adverse drug reaction.
Statistical analysis
To assess the reliability of impact classification, all included enquiries were independently evaluated by two investigators (A.F. and R.B.). Each investigator classified the impact of PVC advice according to the predefined categories (certain, probable, confirmatory, uncertain). Inter-rater agreement was assessed using Cohen’s kappa coefficient [16]. Kappa values were interpreted according to the classification proposed by Landis and Koch, with values above 0.80 considered to indicate almost perfect agreement [16]. In cases of disagreement between the two investigators, a third investigator (C.D.C.) reviewed the case and adjudicated the final classification.
Descriptive statistics were used to summarize the data. Categorical variables are presented as counts and percentages. As this study included all eligible enquiries received during the study period, analyses were descriptive and no formal hypothesis testing or estimation of confidence intervals for descriptive proportions was performed.
Ethics
A retrospective analyze of the data of inpatients and outpatients managed in the Toulouse University Hospital and for which an enquiry was made to the Toulouse PVC in 2024 was performed.
Strict confidentiality was ensured at all times during data collection, storage and analysis. All methods were carried out in accordance with relevant guidelines and regulations.
According to the French Ethics and Regulatory law (public health code), retrospective studies based on the exploitation of usual care data do not have to be submitted to an ethics committee, but they must be declared or covered by the reference methodology of the French National Commission on Informatics and Liberties (CNIL).
A collection and computer processing of personal and medical data was implemented to analyze the results of the research. Toulouse University Hospital signed a commitment of compliance to the reference methodology MR-004 of the French National Commission for Informatics and Liberties (CNIL). After evaluation and validation by the data protection officer and according to the General Data Protection Regulation (Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016), this study completing all the criteria, it is register in the register of data study of the Toulouse University Hospital (32976682) and cover by the MR-004 (CNIL number: 2206723 v 0).
This study was approved by Toulouse University Hospital and confirm that ethic requirements were totally respected in the above report.
According to French law on ethics, clinical trials covered by reference methodology MR-004, patients were informed that their codified data will be used for the study; written consent is not required.
Results
A total of 338 enquiries from Toulouse University Hospital were assessed (Fig. 1). Among them, 210 were excluded for the following reasons: absence of an identifiable patient (n = 161), insufficient clinical information in the electronic patient record to assess impact (n = 18), no involvement of a clinical care (n = 20), inability to determine whether the enquiry preceded or followed the clinical management decision (n = 5), drug-induced harm not considered by treating physicians (n = 4), and duplicate records (n = 2). Ultimately, 128 enquiries were included in the analysis, of which 92 (72%) were submitted before a clinical management decision and 36 (28%) after a clinical management decision.
Fig. 1.
Flowchart of enquiries selection
Enquiries were submitted by healthcare professionals from a wide range of medical department. The department most frequently requesting enquiries were geriatrics (14/128, 10.9%), gastroenterology (11/128, 8.6%), neurology (11/128, 8.6%), infectious diseases (10/128, 7.8%) and internal medicine (10/128, 7.8%). The majority of enquiries concerned adverse drug reactions (n = 111), involved inpatients (n = 100), and were submitted by pharmacists (n = 68) (Table 2). Forty-two (62%) responses to pharmacist-submitted enquiries and 30 (54%) responses to physician-submitted enquiries were documented in the electronic patient record.
Table 2.
Characteristics of enquiries submitted to Toulouse Pharmacovigilance Centre by health professionals at Toulouse University Hospital
| Characteristics | All Enquiries included (N = 128) |
Before clinical intervention (N = 92) |
After clinical intervention (N = 36) |
|---|---|---|---|
| Type of enquiry | |||
| Adverse drug reaction, n (%) | 111 (86.7) | 77 (83.7) | 34 (94.4) |
| Drug interaction, n (%) | 7 (5.5) | 5 (5.4) | 2 (5.6) |
| Rational Use of Medicines, n (%) | 10 (7.8) | 10 (11.1) | 0 (0.0) |
| Type of enquirer | |||
| Pharmacist, n (%) | 68 (53.1) | 50 (54.3) | 18 (50.0) |
| Physician, n (%) | 56 (43.7) | 40 (43.5) | 16 (44.4) |
| Nurse, n (%) | 1 (0.8) | 1 (1.1) | 0 (0.0) |
| Other, n (%) | 3 (2.3) | 1 (1.1) | 2 (5.6) |
| Patients care setting | |||
| Inpatient, n (%) | 100 (78.1) | 69 (75.0) | 31 (86.1) |
| Outpatient, n (%) | 27 (21.1) | 23 (25.0) | 4 (11.1) |
| Unknown, n (%) | 1 (0.8) | 0 (0.0) | 1 (2.8) |
| Concordance between PVC recommendation and clinical management | |||
| Recommendation followed, n (%) | 106 (82.8) | 74 (80.4) | 32 (88.9) |
| Recommendation not followed, with a justified alternative clinical decision, n (%) | 11 (8.6) | 10 (10.9) | 1 (2.8) |
| Recommendation not followed, n (%) | 11 (8.6) | 8 (8.7) | 3 (8.3) |
| PVC advice documented in the EPR, yes | 75 (58.6) | 58 (63.0) | 17 (47.2) |
| ADR reported to the pharmacovigilance system | 50 (39.1) | 34 (37.0) | 16 (44.4) |
ADR adverse drug reaction, EPR electronic patient record, PVC pharmacovigilance centre
The enquiries involved mainly drugs related to the nervous system (23%), particularly psycholeptics such as quetiapine, lithium or mirtazapine. Antiinfectives for systemic use accounted for 22% of the enquiries, particularly antibacterials and antivirals. Antineoplastic and immunomodulating agents accounted for 19% and involved particularly tacrolimus and rituximab. Finally, drugs related to the cardiovascular system; blood and blood-forming organ medications; drugs for the alimentary tract and metabolism accounted for 9%, 8%, and 6% of enquiries.
Overall, 50 (39%) enquiries resulted in a report to the French pharmacovigilance system, including 1 case considered potential safety signal. Clinical management was concordant with PVC recommendations in 111 of 128 cases (87%) (Table 2).
Inter-rater agreement for impact classification was excellent, with a Cohen’s kappa coefficient of 0.88 (z = 16.3, p < 0.001). Agreement between the two reviewers was observed in 117 of 128 cases (91%).
Among enquiries before a clinical management decision had been made, management was concordant with PVC recommendations in 74 of 92 cases (80%). Further, for enquiries before a clinical management decision related to adverse drug reactions (n = 77), clinical management decision was concordant with PVC recommendations in 86% (n = 66/77). Among these 66 enquiries, when evolution was known (n = 55), a clinical improvement was observed in 76% (n = 42/55) of patients. Finally, PVC impact was classified as certain in 62% of cases (n = 57), probable in 24% (n = 22), and uncertain in 14% (n = 13).
Among enquiries submitted after clinical management had already been initiated, PVC advice was classified as confirmatory in 44% of cases (n = 16) and uncertain in 56% (n = 20).
Discussion
In this retrospective study, we showed that PVC recommendations provided in response to patient-specific drug-related enquiries were frequently incorporated into clinical management, with an overall concordance of 83% of all enquiries and an overall mention of the PVC’s advice in the electronic patient record in 58.6% of cases. Among enquiries submitted before a clinical management decision had been made, PVC impact was classified as certain or probable in 86% of cases. Most enquiries concerned adverse drug reactions in hospitalized patients. Among adverse drug reaction-related enquiries for which follow-up information was available, clinical improvement was observed in more than three-quarters of patients. In addition to supporting clinical decision-making, this drug information service activity contributed to pharmacovigilance surveillance, generating 50 reports to the French pharmacovigilance system, including one potential safety signal.
The impact of pharmacovigilance activities, including drug information services, has been insufficiently investigated [17]. To our knowledge, this study is the first in France to evaluate the impact of drug information service of a PVC on clinical decision-making and patient management. As reported for others drug information services, queries regarding adverse drug reactions were the most frequent [4, 18]. While most enquiries were submitted by pharmacists and concerned hospitalized patients, PVC recommendations were frequently documented in the electronic patient record, suggesting their integration into clinical decision-making and their use across different healthcare professionals. Further, the fact that enquiries originated from a wide range of medical specialties highlights the broad integration of PVC expertise into the patient care process, as expected according to the literature [4].
Our findings should be interpreted in the context of the broader literature evaluating Medicines Information Services and Drug Information Centres. A review article from Rutter et al., published in 2019 retrieved 20 studies on Medicines Information Services. They concluded that Medicines Information Services appear to have a positive impact on clinicians’ decision-making and patient care, while highlighting that the available evidence is heterogeneous and largely based on self-reported outcomes [11]. Our study complements this literature by providing an objective assessment of the implementation of PVC recommendations through review of electronic patient records rather than clinician questionnaires or interviews. It therefore extends the evidence supporting the contribution of Drug Information Services to both clinical decision support and pharmacovigilance activities [11–13, 19].
We highlighted the fact that when PVC advice was requested before a clinical decision had been made, the impact was frequently classified as certain, suggesting that PVC recommendations may directly contribute to therapeutic decisions. The high level of concordance observed between PVC recommendations and subsequent clinical management supports the clinical relevance of pharmacovigilance expertise in routine hospital practice. These results are consistent with previous evaluations of Medicines Information Services. Bramley et al. reported that enquirers judged Medicines Information to have a positive impact in 81% of advice, while an independent expert panel considered the advice beneficial in 95% of reviewed enquiries, mainly through reduction of medication-related risk [13]. Similarly, Kauppila et al., reported that recommendations provided by clinical pharmacologists were implemented in 86% of cases and Guignard et al., reported an 84% acceptance rate for interventions made by clinical pharmacologists in a Swiss general internal medicine department [18, 20]. Further, regarding enquiries related to adverse drug reactions, when clinical management decision was concordant with PVC recommendations, a clinical improvement was observed in majority of the cases, as described in the literature [21, 22]. These findings are consistent with the broader role attributed to French PVCs in promoting medication safety and supporting healthcare professionals in complex clinical situations [1, 6, 23].
Most enquiries originated from inpatient settings, which is expected given that pharmacovigilance departments are more frequently consulted in hospitalized patients where complex pharmacotherapy and acute adverse drug reactions are more likely to occur. Nevertheless, a substantial proportion of enquiries (approximately one in five) originated from outpatient consultations, highlighting that PVC support is also used in ambulatory care settings. Our previous work showed that pharmacovigilance interventions, including pharmacological reviews and the identification of potentially inappropriate medications, resulted in a 54% implementation rate of the PVC’s recommendations [24]. Although that study did not specifically evaluate the activities of a drug information service, it highlighted the contribution of pharmacovigilance expertise to prescribing optimisation and patient safety.
A notable proportion of enquiries submitted after a clinical management decision had been made were classified as confirmatory, suggesting that PVC advice is frequently sought to validate or reassess an already implemented therapeutic strategy. This pattern reflects the role of PVCs not only in guiding initial decision-making but also in supporting post hoc clinical reassessment and optimisation of medication safety. This observation is consistent with the review of Rutter et al., that also highlighted the fact that clinicians used Drug Information Centers as a “safety net” to check, reassure or confirm therapeutic decisions [11].
Strengths of this study include its real-world design and inclusion of all consecutive enquiries over a one-year period, limiting selection bias and reflecting routine clinical practice. Cases were independently assessed by two reviewers, with excellent inter-rater agreement, ensuring robustness of the classification process. Finally, the study design based on a full calendar year (2024) was performed at the end of 2025 to minimize the risk of incomplete data due to ongoing hospitalizations or delayed clinical outcomes, thereby improving the completeness and reliability of the dataset. Although monocentric, the study was conducted in a tertiary university hospital, which likely reflects complex clinical setting where pharmacovigilance input is most frequently required.
Several limitations should nevertheless be acknowledged. First, the impact classification used in this study was specifically developed for this analysis and has not been externally validated. In addition, because the classification was developed and applied by investigators working within the PVC, a risk of classification bias cannot be excluded. However, this risk was mitigated by independent assessment by two investigators and adjudication of disagreements by a third investigator. Second, this study suffers from several limits due to its retrospective, cross-sectional and monocentric design. This design may limit the generalizability of our findings and does not allow causal inference regarding the effect of PVC advice on clinical decision-making. Third, as this database was not originally used for research linkage, a substantial number of enquiries had to be excluded because patient identifiers were not available in the PVC database, preventing linkage with the electronic patient record and precluding full assessment of clinical context. Fourth, the assessment of impact relied partly on documentation available in electronic patient records, which may underestimate the true influence of PVC advice, as some recommendations were communicated verbally without formal documentation. Fifth, this study included a limited number of enquiries, particularly those submitted after clinical management had already been initiated, resulting in less precise estimates. Finally, the results of this study are not applicable outside the hospital setting and future research should also focus on community-based healthcare professionals, such as general practitioners and community pharmacists.
Beyond its pharmacovigilance surveillance activity, PVC also contributes to clinical management decision, reinforcing its dual role in clinical decision support and drug safety monitoring. Further multicentric studies are warranted to better characterize the contribution of French PVCs to patient management and to evaluate their potential impact on clinical outcomes and medication safety.
Author contributions
R.B. and C.D.C were involved in conception, acquisition, analysis of data and wrote the main manuscript text. A.F. was involved in acquisition, analysis and drafted the manuscript. P.S., F.M., and H.B. were involved in conception and critically revised the manuscript. All authors approved the version to be published and agreed to be accountable for all aspects of this work.
Funding
None.
Data availability
The data are not publicly available as they are included in the database of Toulouse pharmacovigilance center.
Declarations
Ethics approval
N/A.
Patient consent
N/A.
Permission to reproduce material from other sources
N/A.
Clinical trial registration
N/A.
Artificial intelligence (AI)
AI tools were used to assist with language editing and translation during the preparation of the manuscript. The authors reviewed and approved all AI-assisted content and take full responsibility for the accuracy and integrity of the final manuscript.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s note
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References
- 1.Montastruc J-L, Sommet A, Lacroix I et al (2006) Pharmacovigilance for evaluating adverse drug reactions: value, organization, and methods. Joint Bone Spine 73:629–632. 10.1016/j.jbspin.2006.09.002 [DOI] [PubMed] [Google Scholar]
- 2.Shivabasappa S, Srinivasan A (2025) Drug Information Centre. In: Arivazhahan A, Shah N, Sandhiya S, Raj GM (eds) Introduction to Basics of Pharmacology and Toxicology: Volume 4: Pharmacology and Therapeutics. Springer Nature, Singapore, pp 51–62 [Google Scholar]
- 3.Blayac JP, Haramburu F, Lerebours S, Vial T (2000) [Drug information and prescription guidance: role of regional centers of pharmacovigilance]. Presse Med 29:115–118 [PubMed] [Google Scholar]
- 4.Heck J, Stichtenoth DO, Sabau R et al (2022) Clinical-pharmacological drug information center of Hannover Medical School: experiences and analysis from a tertiary care university hospital. Sci Rep 12:19409. 10.1038/s41598-022-24005-y [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Nilsson J, Kindblom JM, Izsak J (2024) Analysis of queries to a Swedish drug information centre identifies scientific knowledge gaps. Sci Rep 14:30412. 10.1038/s41598-024-82324-8 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Lacroix C, Mallaret M, Jonville-Bera A-P (2020) Pharmacovigilance and drug-induced rare diseases: Strengths of the French Network of Regional Pharmacovigilance Centres. Therapies 75:207–213. 10.1016/j.therap.2020.02.012 [DOI] [PubMed] [Google Scholar]
- 7.Strobach D, Pudritz Y, Huttner D (2024) Retrospective analysis of adverse drug reaction enquiries to a hospital drug information service: lessons to be learned to increase in-hospital drug safety. Int J Pharm Pract 32:384–391. 10.1093/ijpp/riae036 [DOI] [PubMed] [Google Scholar]
- 8.Innes AJ, Bramley DM, Wills S (2014) The impact of UK Medicines Information services on patient care, clinical outcomes and medicines safety: an evaluation of healthcare professionals’ opinions. Eur J Hosp pharmacy-Science Pract 21:222–228. 10.1136/ejhpharm-2014-000462 [DOI] [Google Scholar]
- 9.Bertsche T, Hämmerlein A, Schulz M (2007) German national drug information service: user satisfaction and potential positive patient outcomes. Pharm World Sci 29:167–172. 10.1007/s11096-006-9041-7 [DOI] [PubMed] [Google Scholar]
- 10.Ngo FLU, Garcia KES, Loquias MM et al (2024) Perceptions of Clients on a University-based Drug Information Service affecting Medication Safety. Acta Med Philipp 58:29–36. 10.47895/amp.vi0.7672 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Rutter J, Rutter P (2019) Impact of pharmacy medicine information service advice on clinician and patient outcomes: an overview. Health Info Libr J 36:299–317. 10.1111/hir.12270 [DOI] [PubMed] [Google Scholar]
- 12.Amundstuen Reppe L, Spigset O, Schjøtt J (2016) Drug Information Services Today: Current Role and Future Perspectives in Rational Drug Therapy. Clin Ther 38:414–421. 10.1016/j.clinthera.2015.12.019 [DOI] [PubMed] [Google Scholar]
- 13.Bramley DM, Innes AJ, Duggan C, Oborne CA (2013) The impact of Medicines Information enquiry answering on patient care and outcomes. Int J Pharm Pract 21:393–404. 10.1111/ijpp.12018 [DOI] [PubMed] [Google Scholar]
- 14.CRPV de Toulouse et Montpellier In: RFCRPV. https://www.rfcrpv.fr/bulletins-des-crpv/bip-occitanie-toulouse-montpellier/. Accessed 9 Sept 2026
- 15.Safety signal | European Medicines Agency (EMA) https://www.ema.europa.eu/en/glossary-terms/safety-signal. Accessed 19 June 2026
- 16.Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174 [PubMed] [Google Scholar]
- 17.van Hunsel F, Gardarsdottir H, de Boer A, Kant A (2019) Measuring the impact of pharmacovigilance activities, challenging but important. Br J Clin Pharmacol 85:2235–2237. 10.1111/bcp.14042 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Kauppila M, Backman JT, Lapatto-Reiniluoto O (2026) Clinical pharmacology consultations and their implementation in clinical decision making. Br J Clin Pharmacol 92:1069–1077. 10.1002/bcp.70337 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 19.Almuqbil M, Alrojaie L, Alturki H et al (2022) The role of drug information centers to improve medication safety in Saudi Arabia - a study from healthcare professionals’ perspective. Saudi Pharm J 30:377–381. 10.1016/j.jsps.2022.01.024 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Guignard B, Bonnabry P, Perrier A et al (2015) Drug-related problems identification in general internal medicine: The impact and role of the clinical pharmacist and pharmacologist. Eur J Intern Med 26:399–406. 10.1016/j.ejim.2015.05.012 [DOI] [PubMed] [Google Scholar]
- 21.Cardoni AA, Thompson TJ (1978) Impact of drug information services on patient care. Am J Hosp Pharm 35:1233–1237 [PubMed] [Google Scholar]
- 22.Melnyk PS, Shevchuk YM, Remillard AJ (2000) Impact of the dial access drug information service on patient outcome. Ann Pharmacother 34:585–592. 10.1345/aph.19173 [DOI] [PubMed] [Google Scholar]
- 23.Vial T (2016) French pharmacovigilance: Missions, organization and perspectives. Therapies 71:143–150. 10.1016/j.therap.2016.02.029 [DOI] [PubMed] [Google Scholar]
- 24.Zacarin A, Gonzales C, Nigon D et al (2023) Impact of medication reviews on drug-related problems (DRPs) in older patients living in nursing homes in West Occitania. Fundam Clin Pharmacol 37:182–190. 10.1111/fcp.12820 [DOI] [PMC free article] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data are not publicly available as they are included in the database of Toulouse pharmacovigilance center.