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Challenges and Opportunities for Pharmacoepidemiology in Drug-Therapy Decision Making

From the Division of Clinical Epidemiology, Royal Victoria Hospital and McGill Health Center, Montreal, Canada (Dr Etminan); the Center for Clinical Epidemiology and Evaluation, Vancouver Hospital, Vancouver, Canada (Dr Etminan, Mr FitzGerald); Department of Medicine, Queen's University, Kingston, Ontario, Canada (Dr Gill); Faculty of Medicine, University of British Columbia, Vancouver, Canada (Mr FitzGerald); and the Department of Neurology, University of Washington School of Medicine, Seattle, Washington, (Dr Samii).

Pharmacoepidemiology is a relatively new and evolving science that attempts to quantify mainly adverse drug events and patterns of drug use in a large population. The strength of pharmacoepidemiology over randomized trials is the ability to quantify rare adverse events that may occur over long periods. Recently, discordance in the results of pharmacoepidemiologic studies has made it difficult for clinicians and policy makers to make informed drug-therapy decisions. This commentary addresses the strength of pharmacoepidemiology and the advances in the methodology of pharmacoepidemiologic studies over the years. We also discuss the potential problem of discordant results and urge pharmacoepidemiologists to develop good practice guidelines for the conduct of pharmacoepidemiologic studies.

Key Words: Pharmacoepidemiology • drug safety • case-control studies • cohort studies

Address for reprints: Dr Mahyar Etminan, Center for Clinical Epidemiology and Evaluation, Vancouver Hosptial, 7th Floor, 828 West 10th Avenue, Vancouver, B.C., Canada (metminan{at}shaw.ca).

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