Skip to main content Accessibility help
×
Home
Hostname: page-component-55b6f6c457-cn8nj Total loading time: 0.196 Render date: 2021-09-27T11:41:38.525Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Veterans Affairs Databases

Published online by Cambridge University Press:  07 November 2014

Francesca Cunningham*
Affiliation:
Dr. Cunningham is director of the Center for Medication Safety PSCI at the National Center for Patient Safety and program director of outcomes research at the Department of Veterans Affairs Pharmacy Benefits Management/Strategic Healthcare Group in Hines, Illinois.

Abstract

Pharmacoepidemiology, the study of the effects of drugs in large numbers of people, is a relatively new discipline that applies the methods of epidemiology to clinical pharmacology. Premarketing clinical trials remain the only way to scientifically determine whether a drug is causally effective, yet these trials do not provide information that allows for estimates about rare, late, or off-label toxicities associated with the drug in question. Increasing concern about common and debilitating adverse effects of medications has highlighted the need for enhanced postmarketing surveillance to follow up on clinical trials. There is a further concern regarding the broader issue of the risk-benefit ratio of certain medications. Computerized databases are a good source of information on which to lay the foundations of postmarketing research. A system of cross-linked computerized medical records may better enable researchers and physicians to realistically monitor postmarketing safety and incorporate monitoring benefits. The same research could also elucidate the net public health effect of regulatory decisions. The Veterans Affairs database in the United States and PHARMO in the Netherlands may represent good models on which to base future postmarketing surveillance studies.

In this expert roundtable supplement, Brian L. Strom, MD, provides an overview of the appropriate use of large computer databases in pharmacoepidemiology studies. Philip Wang, MD, DrPH, discusses the advantages of pharmacoepidemiologic studies over clinical trials in correctly detecting drug safety issues. Francesca Cunningham, PharmD, reviews a large computer database that is currently in use within the VA healthcare system, and Ron M.C. Herings, PharmD, PhD, discusses the development of the PHARMO system in the Netherlands.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Smith, MW, Joseph, GJ. Pharmacy Data in the VA Health Care System. Med Care Res Rev. 2003;60(3 Suppl):92S123S.CrossRefGoogle ScholarPubMed
2.Sales, MM, Cunningham, FE, Glassman, PA, Valentino, MA, Good, CB. Pharmacy benefits management in the Veterans Health Administration: 1995 to 2003. Am J Manag Care. 2005;11(2):104112.Google ScholarPubMed
3. Veterans Affairs Center for Medication Safety. Available at: http://www.pbm.va.gov/VACenterForMedicationSafety-Index.aspx. Accessed August 20, 2007.Google Scholar
4.Furmaga, EM, Glassman, PA, Cunningham, FE, Good, CB. Using a national pharmaceutical database to reduce prescribing of short-acting nifedipine in patients with hypertension. Advances in Patient Safety: From Research to Implementation. April 2005; AHRQ Publication No. 05–0021.Google Scholar
1
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Veterans Affairs Databases
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Veterans Affairs Databases
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Veterans Affairs Databases
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *