Pharmacovigilance Can Contribute to Study Adverse Drug Reactions Associated with Use of Online Health Information*

Marco Masoni* Maria Renza Guelfi*
Marco Masoni*, Department of Experimental and Clinical Medicine - University of Firenze, Firenze, Italy
Maria Renza Guelfi*, Department of Experimental and Clinical Medicine - University of Firenze, Firenze, Italy
Antonio Conti, Department of Biomedical Experimental and Clinical Science - University of Firenze, Firenze, Italy
Jonida Shtylla, Department of Experimental and Clinical Medicine - University of Firenze, Firenze, Italy
Gian Franco Gensini, Department of Experimental and Clinical Medicine - University of Firenze, Firenze, Italy

Track: Research
Presentation Topic: Health information on the web: Supply and Demand
Presentation Type: Oral presentation
Submission Type: Single Presentation

Building: Mermaid
Room: Room 3 - Upper River Room
Date: 2013-09-24 10:00 AM – 11:00 AM
Last modified: 2013-09-25

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Background: In the last years, many studies have been published in the biomedical literature about variable quality of medical information on the Internet. At the end the majority of them warns about harm that Internet users can have from using inaccurate and misleading information. But the health impact of this issue is unclear.
A systematic review by Crocco (2002) has retrieved very few publications, especially case reports, about harm deriving from use of online health information. The study resolves that there is not almost any evidence of harm to patients and citizens from the Internet. Since this study, to our knowledge, no other systematic review about this issue was published.
Conversely, other Authors claimed that medical misinformation on the Internet is a main area of concern. Interestingly, in 2001, a Database of Adverse Events Related to the Internet (DAERI) was created, soliciting doctors and patients to submit cases or situations acquainted of or published in lay publications such as newspapers. Unfortunately DAERI is no longer available online and, to our knowledge, no data has ever been published about it.
Objective: This paper suggests to use the international pharmacovigilance system to obtain more knowledge on Adverse Drug Reactions (ADRs) associated with use of online health information. Internet health information could cause patients to modify their adherence to prescribed therapy or to other decisions that might contribute to an ADR. We are aware that the harms caused by the Internet health information may not solely be confined to inappropriate use of medication. Other different types of harm exist such as self-diagnosis, late or misdiagnosis, self-harm or attempt or committed suicide, false hope or state of anxiety. The study of these types of harm lies outside the aim of this paper.
Methods: We have analyzed currently used ADR forms for healthcare professionals and consumers in Italy, the UK and the USA.
Results: From the analysis of the ADR forms of these three countries, the internet dimension seems to be relevant in terms of issues related to online purchasing of drugs. None of the forms contains questions aimed to find and understand whether online health information has contributed to ADRs. We suggest to modify ADR forms to include questions that aim to investigate if online health resources, originating from Websites blogs social networking sites, have drawn attention and have influenced the decision making process that has led the patient to assume a drug, even in combination with other medication. In this way new type of data from ADR forms could be collected in central databases to allow their analysis and monitoring.
The tendency of WHO is to gradually widen the aims of the pharmacovigilance to include food additives, herbal medicines, vaccines and cosmetics. The application of the Authors’ study could apply to these further areas.
Conclusions: New collected data in pharmacovigilance databases could help to better understand patterns of drug use within the society and to shed light on the blurred area of harm derived from the use of inaccurate online health information. Furthermore, new information could be obtained to draw countermeasures and policies for the benefits of public health.

* Notification statement: some of the material has been reused with permissions from a recently accepted publication in Trends in Pharmacological Sciences (DOI: 10.1016/

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