Medications Adverse Effects on Voice: Comparison Between Different Sources of Information

Leonardo da Rocha Cardoso; Patrícia Melo Aguiar; Katia Nemr; Marcia Simões Zenari

doi:10.1016/j.jvoice.2022.12.005

Medications Adverse Effects on Voice: Comparison Between Different Sources of Information

J Voice. 2023 Jan 5:S0892-1997(22)00393-9. doi: 10.1016/j.jvoice.2022.12.005. Online ahead of print.

Authors

Leonardo da Rocha Cardoso¹, Patrícia Melo Aguiar², Katia Nemr², Marcia Simões Zenari³

Affiliations

¹ Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, Brazil.
² Departamento de Farmácia, Faculdade de Ciências Farmacêuticas, Universidade de Sao Paulo, Sao Paulo, Brazil.
³ Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, Brazil. Electronic address: marciasz@usp.br.

PMID: 36610808
DOI: 10.1016/j.jvoice.2022.12.005

Abstract

Introduction: The analysis of drugs with adverse effects on voice provides relevant data for the vocal clinic. It is essential that professionals involved in voice care are aligned on the topic of voice pharmacovigilance in order to understand adverse effects from safe and reliable sources.

Objectives: To compare the voice adverse effects of self-reported medications by dysphonic individuals in different sources of information.

Methods: Descriptive and analytical study based on self-reported active ingredients by dysphonic individuals and their adverse effects on voice listed in Electronic Database of the National Health Surveillance Agency of Brazil (Anvisa). Adverse effects were comparatively analyzed between the Anvisa's Electronic Database and information from the Micromedex and UpToDate databases. Data were analyzed using descriptive and inferential statistics that compared the three sources researched in relation to the number of adverse effects and in relation to the occurrence of adverse effects to the voice.

Results: There was a statistically significant difference between the databases regarding the occurrence of adverse effects of cough, dyspnea, xerostomia, vomiting and hoarseness, with a higher occurrence in the UpToDate database. The UpToDate database showed a statistically significant difference in the amount of drug effects compared to the Anvisa database (P < 0.001, d = 0.744) and compared to the Micromedex database (P < 0.001, d = 0.598), and in the two cases the mean number of drug effects was higher for the UpToDate database.

Conclusions: UpToDate proved to be the most suitable source to complement the data from the medication package inserts at the time of the speech-language pathology assessment. It is recommended that professionals from all countries involved in voice care seek additional evidence-based sources of information to gain access to accurate and up-to-date data on adverse effects of drugs on voice.

Keywords: Drug adverse effect—Voice—Pharmacovigilance—Dysphonia—Speech-language pathology.