Assessment of Risk Evaluation and Mitigation Strategies (REMS) for varenicline (Chantix): A multistage patient survey

Pharmacoepidemiol Drug Saf. 2018 Mar;27(3):253-262. doi: 10.1002/pds.4373. Epub 2018 Feb 6.

Abstract

Purpose: To evaluate the Risk Evaluation and Mitigation Strategies (REMS) for varenicline by assessing patients' understanding of the varenicline medication guide (MG) at pre-specified time points: 18 months, 3 years, and 7 years after the REMS approval.

Methods: Self-administered surveys were mailed to people who received varenicline based on a pharmacy dispensing. Survey questions assessed understanding of potential risks outlined in the MG: neuropsychiatric symptoms, skin reactions, allergic reactions, and cardiovascular risks. Crude and weighted analyses were conducted.

Results: The response to the survey overall was between 18% and 19%. Among responders, approximately 90% recalled receiving the MG, and at least 80% read all or part of it. At least 88% correctly identified neuropsychiatric symptoms as potential medication effects, while 41% did so for skin reactions, 53% for allergic reactions, and 82% for cardiovascular risks. Patients who read the MG had a high proportion of correct responses to the risk comprehension questions.

Conclusions: A large majority of patients who were dispensed varenicline recalled receiving the MG and were able to correctly recall neuropsychiatric and cardiovascular risks in all 3 surveys. The varenicline MG may be an effective tool for patient education.

Keywords: REMS; medication guide; pharmacoepidemiology; risk management; risk mitigation evaluation; smoking cessation; survey; varenicline.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Drug Labeling*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Patient Education as Topic / methods
  • Risk Evaluation and Mitigation*
  • Smoking Cessation / methods
  • Smoking Cessation Agents / administration & dosage
  • Smoking Cessation Agents / adverse effects*
  • Surveys and Questionnaires / statistics & numerical data
  • Varenicline / administration & dosage
  • Varenicline / adverse effects*
  • Young Adult

Substances

  • Smoking Cessation Agents
  • Varenicline