Information to the Physician: Role of French Regional Pharmacovigilance Centres

Regional Pharmacovigilance Centres (RPC), created in 1972, now number 30. Since May 1984, they have had a threefold function: (1) collecting and evaluating unexpected or toxic effects of drugs, (2) disseminating information regarding drugs, and (3) research. In 1988, the annual number of validated Adverse Drug Reactions (ADRs) was in excess of 10,000, that of queries was nearly 20,000, and that of overdoses still far higher. Queries may be broken down into pharmacological advice, concerning a specific patient, general information about drugs, ADRs transmitted to another RPC closer to the patient, ADRs not clearly identified by the notifying physician, and ADRs recognized as such later on. Pharmacological advice may be requested before or after the drug intake. It mainly concerns pregnancy, breast feeding, drug interactions, and pharmacogenetic problems. The origin of queries and ADRs is essentially physicians (89.5%). The information activity of RPC includes organizing meetings, scientific articles (eg, nearly 200 in 1987), or conferences. Their educational role includes postgraduate training for physicians (eg, 110 meetings in 1987) and nurses, postgraduate teaching, didactic publications, pharmacovigilance columns in the medical press, and even TV interviews. The personnel of RPC is mainly composed of physicians (1½ full-time equivalent, on average). It also includes pharmacists and resident medical students. All centers are headed by a physician, professor of clinical or experimental pharmacology or clinical toxicology, and operate in a regional teaching hospital. Their resources include subscriptions to medical journals, access to data banks and data bases, a data processing network (via the French Transpac system), and electronic mail (via the Teletel teletext system). While all ADRs have been computer processed since 1976, the automatic processing of queries is currently at an experimental stage. An early warning system, based on queries, is also envisaged at present.