The Harm of Medication: From Early Identification to Prevention

  • 10k

    Total Downloads

  • 49k

    Total Views and Downloads

About this Research Topic

Submission closed

Background

In 2017, the World Health Organization (WHO) announced its third global patient safety challenge, Medication Without Harm, which aims to reduce the global burden of iatrogenic medication-related harm by 50% within five years. Adverse drug events (ADEs) are considered to be among the leading causes of morbidity and mortality. An estimated 5–25% of hospital admissions are due to ADEs, and 6–15% of hospitalized patients experience serious ADEs, causing significant prolongation of hospital stay. Moreover, fatal ADEs are estimated to occur in 0.31% of hospitalized patients. At present, most hospitals participate in pharmacovigilance through spontaneous reporting systems of ADEs. However, spontaneous reporting systems have limitations such as under-reporting. Active pharmacovigilance programs, may supplement such systems.

THE EARLY IDENTIFICATION

ADEs mimic natural disease states and may thus go undetected. Because ADEs are difficult to detect, practitioners may also prescribe pharmacotherapy for an unrecognized ADE, increasing the risk of additional ADEs. ADEs may also cause patients to lose confidence in or have negative emotions towards their physicians and seek self-treatments options, which may consequently precipitate additional ADEs. In addition, ADEs are rarely specific for a drug, diagnostic tests are usually absent and a re-challenge is rarely ethically justified. On the other hand, misdiagnosis may impose unnecessary restrictions. The evaluation of the causality in an ADE is fundamental to carry out an appropriate handling of the patient, since it allows avoiding a possible re-exposure to the drug in the future. A few years ago, causality assessment was completely dependent on expert judgment (known as global introspection) but with great variability in the results. The algorithms of causality have lower variability and a very high sensitivity, but have a low specificity when there are several suspicious drugs. Therefore, it is necessary to carry out studies that allow the development and implementation of increasingly precise tests, to an early identification of the culprit drug of an ADE and in general the knowledge of the safety of drugs.

PREVENTION

Safe and appropriate prescribing is a complex process, involving issues of over-prescription, under-prescription, inappropriate prescription, prescription in high risk situation, interaction prescription, rechallenge to a drug that causes harm, and transitions of care. Special populations, including women, children, the elderly, pregnant women and patients with concurrent disease states, are also at risk because of changes in pharmacokinetics, pharmacodynamics, pharmacogenetics, genomics or metabolomics. The initiatives to reduce the harm of medication span multiple levels, such as: (a) empowerment of patients, caregivers, and the general public; (b) health information systems; (c) clinical decision-making across health care provider and professional groups; (d) health and social policies related to prescribing appropriateness; and (e) research and innovation related to a better prescribing. Each of these actions/initiatives constitutes an important cross-cutting element to bring about health system change to promote a medication without harm.

The aim of this Research Topic is to assemble review and original research of ADE early detection, identification of the culprit drug and treatment strategies. ADE reporting programs around the world are collected. Strategies in preventing ADEs are very welcome.

Keywords: Adverse drug effect, medication without harm, pharmacovigilance, pharmacoepidemiology, causality assessment

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

Frequently asked questions

  • Frontiers' Research Topics are collaborative hubs built around an emerging theme.Defined, managed, and led by renowned researchers, they bring communities together around a shared area of interest to stimulate collaboration and innovation.

    Unlike section journals, which serve established specialty communities, Research Topics are pioneer hubs, responding to the evolving scientific landscape and catering to new communities.

  • The goal of Frontiers' publishing program is to empower research communities to actively steer the course of scientific publishing. Our program was implemented as a three-part unit with fixed field journals, flexible specialty sections, and dynamically emerging Research Topics, connecting communities of different sizes and maturity.

    Research Topics originate from the scientific community. Many of our Research Topics are suggested by existing editorial board members who have identified critical challenges or areas of interest in their field.

  • As an editor, Research Topics will help you build your journal, as well as your community, around emerging, cutting-edge research. As research trailblazers, Research Topics attract high-quality submissions from leading experts all over the world.

    A thriving Research Topic can potentially evolve into a new specialty section if there is sustained interest and a growing community around it.

  • Each Research Topic must be approved by the specialty chief editor, and they fall under the editorial oversight of our editorial boards, supported by our in-house research integrity team. The same standards and rigorous peer review processes apply to articles published as part of a Research Topic as for any other article we publish.

      In 2023, 80% of the Research Topics we published were edited or co-edited by our editorial board members, who are already familiar with their journal's scope, ethos, and publishing model. All other topics are guest edited by leaders in their field, each vetted and formally approved by the specialty chief editor.

  • Publishing your article within a Research Topic with other related articles increases its discoverability and visibility, which can lead to more views, downloads, and citations. Research Topics grow dynamically as more published articles are added, causing frequent revisiting, and further visibility.

    As Research Topics are multidisciplinary, they are cross-listed in several fields and section journals – increasing your reach even more and giving you the chance to expand your network and collaborate with researchers in different fields, all focusing on expanding knowledge around the same important topic.

    Our larger Research Topics are also converted into ebooks and receive social media promotion from our digital marketing team.

  • Frontiers offers multiple article types, but it will depend on the field and section journals in which the Research Topic will be featured. The available article types for a Research Topic will appear in the drop-down menu during the submission process.

    Check available article types here 

  • Yes, we would love to hear your ideas for a topic. Most of our Research Topics are community-led and suggested by researchers in the field. Our in-house editorial team will contact you to talk about your idea and whether you’d like to edit the topic. If you’re an early-stage researcher, we will offer you the opportunity to coordinate your topic, with the support of a senior researcher as the topic editor. 

    Suggest your topic here 

  • A team of guest editors (called topic editors) lead their Research Topic. This editorial team oversees the entire process, from the initial topic proposal to calls for participation, the peer review, and final publications.

    The team may also include topic coordinators, who help the topic editors send calls for participation, liaise with topic editors on abstracts, and support contributing authors. In some cases, they can also be assigned as reviewers.

  • As a topic editor (TE), you will take the lead on all editorial decisions for the Research Topic, starting with defining its scope. This allows you to curate research around a topic that interests you, bring together different perspectives from leading researchers across different fields and shape the future of your field. 

    You will choose your team of co-editors, curate a list of potential authors, send calls for participation and oversee the peer review process, accepting or recommending rejection for each manuscript submitted.

  • As a topic editor, you're supported at every stage by our in-house team. You will be assigned a single point of contact to help you on both editorial and technical matters. Your topic is managed through our user-friendly online platform, and the peer review process is supported by our industry-first AI review assistant (AIRA).

  • If you’re an early-stage researcher, we will offer you the opportunity to coordinate your topic, with the support of a senior researcher as the topic editor. This provides you with valuable editorial experience, improving your ability to critically evaluate research articles and enhancing your understanding of the quality standards and requirements for scientific publishing, as well as the opportunity to discover new research in your field, and expand your professional network.

  • Yes, certificates can be issued on request. We are happy to provide a certificate for your contribution to editing a successful Research Topic.

  • Research Topics thrive on collaboration and their multi-disciplinary approach around emerging, cutting-edge themes, attract leading researchers from all over the world.

  • As a topic editor, you can set the timeline for your Research Topic, and we will work with you at your pace. Typically, Research Topics are online and open for submissions within a few weeks and remain open for participation for 6 – 12 months. Individual articles within a Research Topic are published as soon as they are ready.

    Find out more about our Research Topics

  • Our fee support program ensures that all articles that pass peer review, including those published in Research Topics, can benefit from open access – regardless of the author's field or funding situation.

    Authors and institutions with insufficient funding can apply for a discount on their publishing fees. A fee support application form is available on our website.

  • In line with our mission to promote healthy lives on a healthy planet, we do not provide printed materials. All our articles and ebooks are available under a CC-BY license, so you can share and print copies.