Pharmacovigilance, hémovigilance, vaccinovigilance, tératovigilance… : quelles retombées imprévues pour les patients, les intervenants de santé et les systèmes de soins ?
Abstract
Over the past five decades, our health systems have set up pharmacovigilance bodies, which monitor the occurrence of adverse drug reactions and improve the safety of medicines through modifications of prescription instructions. Blood products, vaccines, medical devices etc. justified the establishment of similar organizations. This article reviews, with a socio-historical perspective, the construction and functioning of these structures through a number of crises that punctuated their development. The collection, analysis and exploitation of adverse events by dedicated professionals certainly produce some of the expected results in terms of drug safety, at the cost not only of significant investments, but also of accumulating issues inducing definite changes in collective representations related to medicines, with further extension to doctor-patient relationships and health preservation behaviors. Still incompletely appreciated, these unintended consequences tend to deeply transform the context of health behavior and healthcare use.
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