Review of Challenges in Performing Real-World Evidence Studies for Nonprescription Products

Christian Maihöfner,1 Theresa Mallick-Searle,2 Jan Vollert,3 Pranab Kalita,4 Vidhu Sood Sethi5 1Department of Neurology, General Fürth Hospital, University of Erlangen, Fürth, Germany; 2Division of Pain Medicine, Stanford Health Care Pain Management Clinic, Palo Alto, CA, USA; 3Department of Clinica...

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Main Authors: Maihöfner C, Mallick-Searle T, Vollert J, Kalita P, Sood Sethi V
Format: Article
Language:English
Published: Dove Medical Press 2025-01-01
Series:Pragmatic and Observational Research
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Online Access:https://www.dovepress.com/review-of-challenges-in-performing-real-world-evidence-studies-for-non-peer-reviewed-fulltext-article-POR
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author Maihöfner C
Mallick-Searle T
Vollert J
Kalita P
Sood Sethi V
author_facet Maihöfner C
Mallick-Searle T
Vollert J
Kalita P
Sood Sethi V
author_sort Maihöfner C
collection DOAJ
description Christian Maihöfner,1 Theresa Mallick-Searle,2 Jan Vollert,3 Pranab Kalita,4 Vidhu Sood Sethi5 1Department of Neurology, General Fürth Hospital, University of Erlangen, Fürth, Germany; 2Division of Pain Medicine, Stanford Health Care Pain Management Clinic, Palo Alto, CA, USA; 3Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK; 4Global Category Medical Affairs, Haleon Plc, Weybridge, England, UK; 5Global Medical Affairs, GSK Consumer Healthcare Singapore Pte. Ltd, SingaporeCorrespondence: Vidhu Sood Sethi, GSK Consumer Healthcare Singapore Pte Ltd (Co Regn No. 201309040M), 23 Rochester Park #03-02, 139234, Singapore, Tel +6596447203, Email vidhu.x.sethi@haleon.comAbstract: In recent years, regulatory authorities have signaled a willingness to consider real-world evidence (RWE) data to support applications for new claims and indications for pharmaceuticals. Historically, RWE studies have been the domain of prescription drugs, driven by the fact that clinical data on patients are routinely captured in medical records, claims databases, registries, etc. However, RWE reports of nonprescription drugs and supplements are relatively sparse due to methodological gaps in this area. The objective of this narrative review is to identify which RWE methodologies have been used to study nonprescription products. A total of 49 articles were included based on literature searches. Label comprehension studies, used to support prescription-to-nonprescription switches, are useful in determining how nonprescription products will be used; however, they provide no actual clinical data. The most common RWE studies of nonprescription products were cross-sectional surveys, which investigated a broad range of indications and were conducted in an array of settings, including online, by phone, point-of-sale (pharmacy), outpatient clinics, and shopping malls. However, while this type of study is effective for identifying use patterns and attitudes in the general population, recall bias limits the ability to collect safety and effectiveness data. Studies of electronic medical records and claims databases are hampered by incomplete or absent capturing of data on nonprescription products. As a result, most RWE studies to date have provided limited useful information. Although case reports and expert opinion should not be discounted, in the absence of other information they provide few actual data. Novel approaches using smartphone apps and artificial intelligence may provide new opportunities to collect RWE for nonprescription products, but these areas of research are in their infancy. Overall, there is a need to develop standards for execution of RWE studies of nonprescription products in terms of endpoints, study design, and study quality.Keywords: cross-sectional studies, dietary supplements, evidence-based practice, nonprescription drugs, research design
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spelling doaj-art-c5f265d7d4bc4a37977342851e1e28012025-01-23T18:50:33ZengDove Medical PressPragmatic and Observational Research1179-72662025-01-01Volume 1671899515Review of Challenges in Performing Real-World Evidence Studies for Nonprescription ProductsMaihöfner CMallick-Searle TVollert JKalita PSood Sethi VChristian Maihöfner,1 Theresa Mallick-Searle,2 Jan Vollert,3 Pranab Kalita,4 Vidhu Sood Sethi5 1Department of Neurology, General Fürth Hospital, University of Erlangen, Fürth, Germany; 2Division of Pain Medicine, Stanford Health Care Pain Management Clinic, Palo Alto, CA, USA; 3Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK; 4Global Category Medical Affairs, Haleon Plc, Weybridge, England, UK; 5Global Medical Affairs, GSK Consumer Healthcare Singapore Pte. Ltd, SingaporeCorrespondence: Vidhu Sood Sethi, GSK Consumer Healthcare Singapore Pte Ltd (Co Regn No. 201309040M), 23 Rochester Park #03-02, 139234, Singapore, Tel +6596447203, Email vidhu.x.sethi@haleon.comAbstract: In recent years, regulatory authorities have signaled a willingness to consider real-world evidence (RWE) data to support applications for new claims and indications for pharmaceuticals. Historically, RWE studies have been the domain of prescription drugs, driven by the fact that clinical data on patients are routinely captured in medical records, claims databases, registries, etc. However, RWE reports of nonprescription drugs and supplements are relatively sparse due to methodological gaps in this area. The objective of this narrative review is to identify which RWE methodologies have been used to study nonprescription products. A total of 49 articles were included based on literature searches. Label comprehension studies, used to support prescription-to-nonprescription switches, are useful in determining how nonprescription products will be used; however, they provide no actual clinical data. The most common RWE studies of nonprescription products were cross-sectional surveys, which investigated a broad range of indications and were conducted in an array of settings, including online, by phone, point-of-sale (pharmacy), outpatient clinics, and shopping malls. However, while this type of study is effective for identifying use patterns and attitudes in the general population, recall bias limits the ability to collect safety and effectiveness data. Studies of electronic medical records and claims databases are hampered by incomplete or absent capturing of data on nonprescription products. As a result, most RWE studies to date have provided limited useful information. Although case reports and expert opinion should not be discounted, in the absence of other information they provide few actual data. Novel approaches using smartphone apps and artificial intelligence may provide new opportunities to collect RWE for nonprescription products, but these areas of research are in their infancy. Overall, there is a need to develop standards for execution of RWE studies of nonprescription products in terms of endpoints, study design, and study quality.Keywords: cross-sectional studies, dietary supplements, evidence-based practice, nonprescription drugs, research designhttps://www.dovepress.com/review-of-challenges-in-performing-real-world-evidence-studies-for-non-peer-reviewed-fulltext-article-PORcross-sectional studiesdietary supplementsevidence-based practicenonprescription drugsresearch design
spellingShingle Maihöfner C
Mallick-Searle T
Vollert J
Kalita P
Sood Sethi V
Review of Challenges in Performing Real-World Evidence Studies for Nonprescription Products
Pragmatic and Observational Research
cross-sectional studies
dietary supplements
evidence-based practice
nonprescription drugs
research design
title Review of Challenges in Performing Real-World Evidence Studies for Nonprescription Products
title_full Review of Challenges in Performing Real-World Evidence Studies for Nonprescription Products
title_fullStr Review of Challenges in Performing Real-World Evidence Studies for Nonprescription Products
title_full_unstemmed Review of Challenges in Performing Real-World Evidence Studies for Nonprescription Products
title_short Review of Challenges in Performing Real-World Evidence Studies for Nonprescription Products
title_sort review of challenges in performing real world evidence studies for nonprescription products
topic cross-sectional studies
dietary supplements
evidence-based practice
nonprescription drugs
research design
url https://www.dovepress.com/review-of-challenges-in-performing-real-world-evidence-studies-for-non-peer-reviewed-fulltext-article-POR
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