实施欧盟临床实践中药品风险最小化措施的挑战 临床实践指南:混合方法 多个案例研究
Mathias Møllebæk1, Helga Gardarsdottir2,3, Alexia-Georgia Bikou4
1Department of Pharmacy, Copenhagen Centre for Regulatory Science, University of Copenhagen, Copenhagen, Denmark. mathias.moellebaek@sund.ku.dk.
Drug safety
|November 21, 2024
概括
风险最小化措施 (RMM) 很少被纳入临床实践指南 (CPG). 这种有限的纳入源于临床医生意识的低,感知到缺乏实用性,以及监管机构和指南开发者之间的合作不足.
科学领域:
- 药监和药物安全 药监和药物安全
- 临床实践指南开发 临床实践指南开发
- 医疗保健政策和法规 医疗保健政策和法规
背景情况:
- 风险最小化措施 (RMMs) 对于安全的药物使用至关重要,但由于各种利益相关者的参与,它们面临实施挑战.
- 临床实践指南 (CPG) 是临床实践中的关键决策工具.
研究的目的:
- 评估RMM在相关CPG中包含的程度.
- 确定影响RMM在CPG中纳入的因素.
主要方法:
- 一个多个案例研究,将CPG的定量文档分析与定性访谈相结合.
- 分析了6个欧盟成员国的5个治疗领域的136个CPG.
- 对71次与CPG开发利益相关方的访谈进行了诱导性分析.
主要成果:
- 只有25%的分析CPG包含RMM信息.
- 关键障碍包括临床医生对RMM的认识低,临床效用低,以及对支持数据的不熟悉.
- 在CGG范围和RMM信息之间存在的不兼容性也阻碍了纳入.
结论:
- 在CPG中包含RMM信息显著有限.
- 解释涉及CPG和RMM的特点,以及监管机构和指南作者之间的脱节.
- 建议加强利益相关者,国家监管机构和EMA之间的合作,以改善实施.
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