Work precarity, employment characteristics and health among Canada's long-term care and seniors' home workers during the COVID-19 pandemic.

Background: The COVID-19 pandemic has highlighted several issues among health care workers in Canada's long-term care and seniors' (LTCS) homes, including labour shortages, staff retention difficulties, overcrowding, and precarious working conditions. There is currently a lack of information on the health, well-being and working conditions of health care workers in LTCS homes - many of them immigrants - and a limited understanding of the relationship between them. This paper examines differences between immigrant and non-immigrant workers' health outcomes and precarious working conditions during the pandemic. Data and methods: The data were from the 2021 Survey on Health Care Workers' Experiences During the Pandemic, which collected information on LTCS home health care workers' (n=2,051) health, employment or work experiences, and working environment during the COVID-19 pandemic. Summary statistics and multivariable logistic regressions were conducted to examine the association between precarious work and workers' health (life stress, mental health and general health), stratified by immigrant status. Selected working characteristics were included in the regression models as covariates, namely occupation, number of locations worked, facility ownership status and number of years worked. Results: Immigrant health care workers were more likely than non-immigrant health care workers to experience precarious work in LTCS homes. Precarious work - characterized by income loss, reduced hours of work, and unpaid leave - was associated with stress and poor general health among immigrant and non-immigrant workers in the sector. Employment precarity was also associated with poor mental health for immigrant workers, but there was no association for non-immigrant workers. Interpretation: Employment precarity and the health and well-being of health care workers warrants further attention, in particular among immigrants employed in the LTCS residential care sector.

Childhood-onset disabilities and lifetime earnings growth: A longitudinal analysis.

This study offers insights into lifetime earnings growth differences between individuals with and without childhood-onset disabilities (COD) defined as disabilities whose onset occurred before an individual's 16th birthday. We use a newly available database linking data from the 2017 Canadian Survey of Disability with individual income tax records covering a period of over 3 decades. We estimate the average earnings growth profiles of individuals with COD from the age when individuals generally enter the labor market to the age when most retire. The main finding of our study is that individuals with COD experience very little earnings growth when they are in their mid-30 and 40s while the earnings of those without COD grow steadily until they reach their late 40s and early 50s. The largest earnings growth differences between individuals with and without COD are observed for male university graduates.

Childhood Abuse, Intimate Partner Violence in Young Adulthood, and Welfare Receipt by Midlife.

OBJECTIVE: To investigate prospective associations between type of child abuse (physical, sexual, both), timing (childhood, young adulthood, both), and welfare receipt into middle-age. METHODS: Database linkage study using the Quebec Longitudinal Study of Kindergarten Children cohort born in 1980 and government administrative databases (N = 3020). We assessed parental tax returns, family and personal background characteristics (1982-1987). At age 22 years, participants answered retrospective questionnaires on experienced childhood abuse (physical, sexual abuse < age 18 years) and intimate partner violence (IPV) (ages 18-22). Main outcome was years on social assistance, on the basis of participant tax returns (ages 23-37 years). Analysis included weights for population representativeness. RESULTS: Of 1690 participants (54.4% females) with available data, 22.4% reported childhood abuse only, 14.5% IPV only, and 18.5% both. Prevalence of childhood physical, sexual, and both was 20.4%, 12.2%, and 8.3%, respectively. Adjusting for socioeconomic background and individual characteristics, we found that childhood physical abuse alone and physical or sexual abuse combined were associated with a two-fold risk of welfare receipt, as compared to never-abused (adjusted incidence risk ratio 2.43, 95% confidence interval [CI], 1.65-3.58; and adjusted incidence risk ratio 2.04, 95% CI, 1.29-3.23, respectively). Repeated abuse (childhood abuse combined with adult IPV) had a three-fold risk (adjusted incidence ratio 3.59, 95% CI, 2.39-5.37). CONCLUSIONS: Abuse across several developmental periods (childhood and young adulthood) is associated with increased risks of long-term welfare receipt, independently of socioeconomic background. Results indicate a dose-response association. Early prevention and targeted identification are crucial to preventing economic adversity that may potentially lead to intergenerational poverty.

Income trajectories of families raising a child with a neurodisability.

PURPOSE: To examine household income trajectories of children with and without neurodisability over a period of 6 years. METHOD: We used four cycles of the Canadian National Longitudinal Survey of Children and Youth, a longitudinal study of the development and well-being of Canadian children from birth into adulthood. RESULTS: While household income increased over time for both groups, families of children with neurodisability had consistently lower household income compared to families of children without neurodisability even after controlling for child and family socio-demographic characteristics. The presence of an interaction effect between parent work status and child with neurodisability at baseline indicated that among children whose parent(s) were not working at baseline, household incomes did not differ between children with and without neurodisability. CONCLUSIONS: The association between child with neurodisability and lower household income may not hold for all types of parents', working status is an important consideration.Implications for RehabilitationFindings support the health selection hypothesis that health status shapes diverging economic conditions over time: children with a ND have lower household incomes than children without a ND child across all waves of the Canadian National Longitudinal Survey of Youth.Income gaps did not increase or decrease over time; rehabilitation services and policies must consider the lower average incomes associated with raising a child with a ND.Social assistance support likely plays a key role in closing the gap, especially for non-working families.

Understanding the Perceived Mental Health of Canadians During the COVID-19 Pandemic.

BACKGROUND: While the physical health implications of the COVID-19 pandemic are regularly publicly available, the mental health toll on Canadians is unknown. This article examines the self-perceived mental health of Canadians during the COVID-19 pandemic and explores associations with various concerns after accounting for socioeconomic and health factors. DATA: The cross-sectional Canadian Perspectives Survey Series 1 collected information related to COVID-19 in late March and early April 2020 concerning labour market participation, behaviours, and health for the Canadian population 15 years and older living in the 10 provinces. METHODS: Socioeconomic and health characteristics of respondents as well as concerns about the impact of COVID-19 were examined to determine differences in experiencing excellent or very good compared to good, fair or poor perceived mental health. RESULTS: Just over half of Canadians aged 15 and older (54%) reported excellent or very good mental health during the COVID-19 pandemic. Several concerns were also associated with mental health. Notably, after considering the effects of socioeconomic and health characteristics, women, youth, individuals with a physical health condition and those who were very or extremely concerned with family stress from confinement were less likely to report excellent or very good mental health. DISCUSSION: These findings point to particular risks for lower perceived mental health during the COVID-19 pandemic. Results highlight various concerns of Canadians which may be associated with mental health, in particular, family stress in the home.

Patients' experiences on adverse drug reactions reporting: a qualitative study.

BACKGROUND: Spontaneous reporting of adverse drug reactions (ADRs) is an important source of information for post-marketing drug safety evaluation. Most countries have public access to reporting systems, but patients report only 3% of all ADRs. Little is known about factors affecting patient reporting. Our aim was to explore patients' experiences reporting ADRs and their views on the usability of the Canadian Vigilance reporting forms on MedEffect. METHODS: An interpretive description qualitative study was used. Adults in Canada, who experienced an ADR, were invited to participate through social media (Kijiji, Facebook, Twitter) and by associations (e.g., Patients Canada or Canadian Arthritis Society). Participants were interviewed in English and French using structured interview guides. Inductive content analysis was used. RESULTS: Fifteen interviews were conducted from October 2014 to May 2015. Two participants reported ADRs to MedEffect, and others to physicians and/or pharmacists. Motives for reporting were intolerable side effect impacting daily activities and encouragement from others to report (e.g., family, colleagues). Factors that interfered with reporting were physicians normalized or minimized the side effect, confusion on what to report, no feedback after report submission to MedEffect, and previous experience with side effects. MedEffect forms were described as comprehensive and important, but its usability was affected by the number of questions and complexity of some questions. CONCLUSIONS: Most participants were unaware of MedEffect and reported ADRs to physicians and pharmacists. Several barriers and motives affected patients' reporting of ADRs. MedEffect form could be simplified for use by patients.

Child Care Attendance and Educational and Economic Outcomes in Adulthood.

OBJECTIVES: To test associations between onset of formal child care (in infancy or as a toddler), high school graduation, and employment earnings from ages 18 to 35 years. METHODS: A 30-year prospective cohort follow-up study, with linkage to government administrative databases (N =3020). Exposure included formal child care, if any, by accredited caregivers in centers or residential settings at ages 6 months and 1, 1.5, 2, 3, and 4 years. A propensity score analysis was conducted to control for social selection bias. RESULTS: Of 2905 participants with data on child care use, 59.4% of male participants and 78.5% of female participants completed high school by age 22 to 23. Mean income at last follow-up (n = 2860) was $47 000 (Canadian dollars) (SD = 37 700) and $32 500 (SD = 26 800), respectively. Using group-based trajectory modeling, we identified 3 groups: formal child care onset in infancy (∼6 months), formal child care onset as a toddler (after 2.5 years), and never exposed. After propensity score weighting, boys with child care started in infancy had greater odds of graduating than those never exposed (odds ratio [OR] 1.39; 95% confidence interval [CI]: 1.18-1.63; P < .001). Boys attending child care had reduced odds of low income as young adults (infant onset: OR 0.60 [95% CI: 0.46-0.84; P < .001]; toddler onset: OR 0.63 [95% CI: 0.45-0.82; P < .001]). Girls' graduation rates and incomes revealed no significant association with child care attendance. CONCLUSIONS: For boys, formal child care was associated with higher high school completion rates and reduced risk of adult poverty. Benefits for boys may therefore extend beyond school readiness, academic performance, and parental workforce participation.

Prescription Drug Use Among Adults Aged 40-79 in the United States and Canada.

Patterns of prescription drug use may reflect underlying patterns of health conditions and health care access in the population. Polypharmacy, often defined as the simultaneous use of five or more prescription drugs, is more common in an aging population where multiple coexisting chronic conditions often occur; however, safety concerns may arise (1). The United States and Canada share many cultural and historical ties, but with different models for health care delivery (2). This report describes the use of one or more and five or more prescription drugs among adults aged 40-79 in the United States and Canada.

Changes in Caregiver Health in the Years Surrounding the Birth of a Child With Health Problems: Administrative Data From British Columbia.

BACKGROUND: Caregivers of children with health problems (CHPs; usually mothers) experience more physical and psychological health problems than those of children without health problems (non-CHPs). Primarily cross-sectional and survey-driven, this literature has not yet explored whether these health differences existed before the birth of the CHPs, or are exacerbated postbirth. METHODS: Using linked administrative health data on all mother-child dyads for children born in the year 2000 in British Columbia, Canada, we examined maternal health before, during, and after the birth of CHPs, and compared it between mothers of CHPs and non-CHPs with piecewise growth curve modeling. RESULTS: Compared with mothers of non-CHPs, mothers of CHPs had more physician visits (8.09 vs. 11.07), more medication types (1.81 vs. 2.60), and were more likely to be diagnosed with selected health conditions (30.9% vs. 42.5%) 4 years before the birth of the child. Over the 7-year postbirth period, the health of the 2 groups of mothers further diverged: while mothers of CHPs showed increases on physician visits and types of medication, mothers of non-CHPs did not experience any changes in physician visits and had less steep increases for types of medication. CONCLUSIONS: Health issues associated with having a child with a health problem may begin well before the birth of the child, but also appear to be exacerbated postbirth. The health challenges of caregivers of CHPs may be multifactorial, involving both preexisting conditions and the stresses associated with caring for a child with health problems.

Changes in the health of mothers of children with neurodevelopmental disabilities: An administrative data study.

BACKGROUND: Using linked administrative health data, this study compared the health and healthcare service utilization between mothers of children with and without neurodevelopmental disabilities (NDD), before, during, and after the birth of a child. METHODS: The population (N = 25,388) was based on a cohort of children born in 2000 and who were, along with their mothers, continuously registered with the British Columbia's universal health insurance program between 2000 and 2007. RESULTS: Compared to mothers of children without NDD, mothers of children with NDD were more likely to have chronic conditions and higher service utilization before child birth. Mothers of children with NDD showed a smaller increase in physician visits in the year before birth but a greater increase in different prescription drugs in the year after birth. There was no further divergence (or convergence) in health and service utilization between the groups in the 7-year period post-birth. CONCLUSIONS: Differences in health and healthcare service utilization between mothers of children with and without NDD existed before the birth of the child and did not diverge in the 7 years post-birth. Replication of these findings is warranted as well as follow-up analyses examining longer term outcomes for mothers beyond 7 years post-birth.

Using Canadian administrative health data to examine the health of caregivers of children with and without health problems: A demonstration of feasibility.

INTRODUCTION: Caregivers of children with health problems experience poorer health than the caregivers of healthy children. To date, population-based studies on this issue have primarily used survey data. OBJECTIVES: We demonstrate that administrative health data may be used to study these issues, and explore how non-categorical indicators of child health in administrative data can enable population-level study of caregiver health. METHODS: Dyads from Population Data British Columbia (BC) databases, encompassing nearly all mothers in BC with children aged 6-10 years in 2006, were grouped using a non-categorical definition based on diagnoses and service use. Regression models examined whether four maternal health outcomes varied according to indicators of child health. RESULTS: 162,847 mother-child dyads were grouped according to the following indicators: Child High Service Use (18%) vs. Not (82%), Diagnosis of Major and/or Chronic Condition (12%) vs. Not (88%), and Both High Service Use and Diagnosis (5%) vs. Neither (75%). For all maternal health and service use outcomes (number of physician visits, chronic condition, mood or anxiety disorder, hospitalization), differences were demonstrated by child health indicators. CONCLUSIONS: Mothers of children with health problems had poorer health themselves, as indicated by administrative data groupings. This work not only demonstrates the research potential of using routinely collected health administrative data to study caregiver and child health, but also the importance of addressing maternal health when treating children with health problems.

Relationship between leisure time physical activity, sedentary behaviour and symptoms of depression and anxiety: evidence from a population-based sample of Canadian adolescents.

BACKGROUND: Physical and sedentary activities have been identified as potentially modifiable risk factors for many diseases, including mental illness, and may be effective targets for public health policy and intervention. However, the relative contribution of physical activity versus sedentary behaviour to mental health is less clear. This study investigated the cross-sectional association between physical activity, sedentary activity and symptoms of depression and anxiety at age 14-15 in the National Longitudinal Survey of Children and Youth (NLSCY). METHODS: Respondents aged 14-15 years between 1996 and 2009 who reported on symptoms of depression in the NLSCY were included (n=9702). Multinomial logistic regression was used to assess the relationship between physical and sedentary activity and symptoms of depression and anxiety. Joint models including both physical and sedentary activity were also explored. Models were adjusted for sex, ethnicity, immigration status, family income, parental education, recent major stressful life events and chronic health conditions. RESULTS: The odds of having moderate and severe symptoms of depression and anxiety compared with no symptoms was 1.43 (1.11 to 1.84) and 1.88 (1.45 to 2.45) times higher, respectively, in physically inactive youth relative to physically active youth. The odds of having moderate and severe symptoms of depression and anxiety compared with no symptoms was 1.38 (1.13 to 1.69) and 1.31 (1.02 to 1.69) times higher, respectively, in sedentary youth relative to non-sedentary youth. In joint models including both physical and sedentary activity, sedentary activity was not consistently associated with symptoms of depression and anxiety. CONCLUSIONS: Both physical inactivity and sedentary activity appear to be significantly related to symptoms of depression and anxiety. The importance of distinguishing these two behaviours has relevance for research as well as policies targeting physical activity and mental health in youth.

Acute care hospitalizations for mental and behavioural disorders among First Nations people.

BACKGROUND: National information about acute care hospitalizations for mental/behavioural disorders among Aboriginal people in Canada is limited. DATA AND METHODS: This study describes acute care hospitalizations for mental /behavioural disorders among First Nations people living on and off reserve. The 2006 Census was linked to the Discharge Abstract Database from 2006/2007 through 2008/2009 for all provinces (except Ontario and Quebec) and the three territories. Hospitalizations for seven types of disorders were identified. "Most responsible" diagnosis and secondary diagnoses were examined separately. Age-standardized hospitalization rates (ASHRs) per 100,000 population and rate ratios were calculated. RESULTS: ASHRs for most responsible and secondary diagnoses of mental/behavioural disorders were significantly higher for First Nations people living on and off reserve than for non-Aboriginal people. The leading diagnoses were the same for each group, but the rank order differed. Among First Nations people, the most common diagnoses were substance-related disorders, mood disorders, and schizophrenic/psychotic disorders. Among non-Aboriginal people, mood disorders were the leading most responsible diagnosis, followed by schizophrenic/psychotic disorders and substance-related disorders. The greatest rate differences between First Nations and non-Aboriginal people for both most responsible and secondary diagnoses were for substance-related disorders. DISCUSSION: The higher burden of hospitalizations due to mental/behavioural disorders among First Nations people provides benchmarks and points to the need of considering every hospital admission as an important opportunity for intervention and prevention. The Truth and Reconciliation Commission of Canada (2015) has recognized that the poorer health outcomes of Aboriginal people in Canada were rooted in the legacies of colonization. Further research is required to better understand the direct impacts on mental health.

Smoking correlates among Inuit men and women in Inuit Nunangat.

BACKGROUND: Although rates of daily smoking among Inuit have been decreasing since 1991, Inuit are still much more likely to smoke relative to the Canadian population as a whole. However, little population-based empirical research has identified characteristics associated with cigarette use among this population. DATA AND METHODS: Based on data from the 2012 Aboriginal Peoples Survey, sex-specific logistic regression analyses, informed by an Inuit social determinants of health framework, described associations between current smoking and selected socio-demographic characteristics among Inuit men and women aged 18 or older who resided in Inuit Nunangat. RESULTS: In 2012, 75% of Inuit men and 74% of Inuit women reported that they smoked cigarettes either daily or occasionally. Inuit men and women had lower odds of smoking if they were high school graduates. Among Inuit men, the odds of smoking were lower for those in higher-income households. Among Inuit women, the odds of smoking were lower for those who had postsecondary education or lived in food-secure households; odds were higher for women who had attended a residential school. Inuit of both sexes had significantly higher odds of smoking if they lived in crowded conditions or in homes where a regular smoker was present. DISCUSSION: Some correlates of smoking among Inuit in Inuit Nunangat appear to be sex-specific. Findings from this study identify some of the protective and risk factors for smoking among this population and can help inform smoking prevention and cessation programs.

Longitudinal child data: What can be gained by linking administrative data and cohort data?

INTRODUCTION: Linked administrative data sets are an emerging tool for studying the health and well-being of the population. Previous papers have described methods for linking Canadian data, although few have specifically focused on children, nor have they described linkage between tax outcomes and a cohort of children who are particularly at risk for poor financial outcomes. OBJECTIVE AND METHODS: This paper describes a probabilistic linkage performed by Statistics Canada linking the Montreal Longitudinal Experimental Study (MLES) and the Quebec Longitudinal Study of Kindergarten Children (QLSKC) survey cohorts and administrative tax data from 1992 through 2012. RESULTS: The number of valid cases in the original cohort file with valid tax records was approximately 84%. Rates of false positives, false negatives, sensitivity, and specificity of the linkage were all acceptable. Using the linked file, the relationship of childhood behavioural indicators and adult income can be investigated in future studies. CONCLUSIONS: Innovative methods for creating longitudinal datasets on children will assist in examining long-term outcomes associated with early childhood risk and protective factors as well as an evidence base for interventions that promote child well-being and positive outcomes.

The Job Content, Context, and Requirements of Regulated Home-Based Childcare Workers.

Contrary to a large and growing literature on center-based childcare workers, we know little about the work and health experiences of those providing childcare services in their homes. This study examines the job content, context, and requirements of regulated Home-Based Childcare workers in Canada. It is based on the qualitative analysis of eleven individual semistructured interviews. These workers perform business administration tasks and more housekeeping and domestic work than those in the center-based childcare, which affect their health and well-being. In addition, they reported factors related to the context and the content of their job such as the high physical and mental efforts, the absence of contact with other adults during working hours, the lack of external help, the exposure to noise and bad odors, the interference of work with personal and family life, the precarious remuneration, and the lack of benefits as potential factors that may affect their health.

Children with neurodevelopmental disorders and disabilities: a population-based study of healthcare service utilization using administrative data.

AIM: The aim of this study was to identify children with neurodevelopmental disorders and disabilities (NDD/D) and compare their healthcare service utilization to children without NDD/D using provincial linked administrative data. METHOD: The sample included children aged 6 to 10 years (n=183 041), who were registered with the British Columbia Medical Services Plan. Diagnostic information was used for the identification and classification of NDD/D in six functional domains. Healthcare service utilization included outcomes based on physician claims, prescription medication use, and hospitalization. RESULTS: Overall, 8.3% of children were identified with NDD/D. Children with NDD/D had higher healthcare service utilization rates than those without NDD/D. Effect sizes were: very large for the number of days a prescription medication was dispensed; large for the number of prescriptions; medium for the number of physician visits, different specialists visited, number of different prescription medications, and ever hospitalized; and small for the number of laboratory visits, X-ray visits, and number of days hospitalized. INTERPRETATION: The findings have policy implications for service and resource planning. Given the high use of psychostimulants, specialized services for both NDD/D and psychiatric conditions may be the most needed services for children with NDD/D. Future studies may examine patterns of physician behaviours and costs attributable to healthcare service utilization for children with NDD/D. WHAT THIS PAPER ADDS: Children with neurodevelopmental disorders and disabilities (NDD/D) have higher healthcare service utilization than those without. Based on provincial population-based linked administrative health data, a sizeable number of children are living with NDD/D. Given the high use of psychostimulants, specialized services for children with both NDD/D and psychiatric conditions may be the most needed services for children with NDD/D.

Acute care hospitalization of Aboriginal children and youth.

BACKGROUND: Research that has examined Aboriginal children's hospitalization rates at the national level has been limited to analyses of areas with large percentages of Aboriginal residents, rather than of Aboriginal individuals. This study uses linked census and administrative data to describe hospitalization patterns among children and youth aged 0 to 19, by Aboriginal identity, for all provinces and territories except Quebec. DATA AND METHODS: The 2006 Census was linked to the 2006/2007-to-2008/2009 Discharge Abstract Database, which contains hospital records from all acute care facilities (except Quebec). Hospital records were examined by Aboriginal identity, as reported to the census, according to International Classification of Diseases chapters based on "the most responsible diagnosis." Age-standardized hospitalization rates (ASHRs) were calculated per 100,000 population, and age-standardized rate ratios (RRs) were calculated for Aboriginal groups relative to non-Aboriginal people. RESULTS: ASHRs were consistently higher among Aboriginal children and youth relative to their non-Aboriginal counterparts; rates for children aged 0 to 9 were 1.4 to 1.8 times higher; for youth aged 10 to 19, 2.0 to 3.8 times higher. For all children aged 0 to 9, the leading cause of hospitalization was "diseases of the respiratory system," but RRs for Aboriginal children ranged from 1.7 to 2.5, compared with non-Aboriginal children. Disparities between Aboriginal and non-Aboriginal 10- to 19-year-olds were pronounced for injuries due to assaults (RRs from 4.8 to 10.0), self-inflicted injuries (RRs from 2.7 to 14.2), and pregnancy, childbirth and the puerperium (RRs from 4.1 to 9.8). INTERPRETATION: Additional research is needed to examine reasons for the disparities in hospitalization rates between Aboriginal and non-Aboriginal children and youth.

Smoking prevalence among Inuit in Canada.

Using data from the 1991, 2001 and 2012 Aboriginal Peoples Survey, this study examines the prevalence of smoking among Inuit aged 15 or older, by location of residence, sex and age group. Overall, the prevalence of daily smoking was significantly lower in 2012 than in 1991; this was true for Inuit living inside and outside Inuit Nunangat, for men and women, for most age groups, and for those in all Inuit regions except Nunavik. The average number of cigarettes smoked per day by daily smokers decreased steadily and significantly over time, except among those living outside Inuit Nunangat or in Nunavik, and those aged 55 or older. The average age of daily smoking initiation remained stable at 15.

Factors affecting patient reporting of adverse drug reactions: a systematic review.

AIM: The aim of the present study was to determine the barriers and motives influencing consumer reporting of adverse drug reactions (ADRs). METHODS: A systematic review, guided by the Cochrane Handbook, was conducted. Electronic searches included MEDLINE, EMBASE, PsycINFO, CINAHL, PubMed and the Cochrane Database of Systematic Reviews from 1964 to December 2014. Eligible studies addressed patients' perceptions and factors influencing ADR reporting. Studies about healthcare professional (HCP) reporting of ADRs were excluded. Studies were appraised for quality, and results were analysed descriptively. RESULTS: Of 1435 citations identified, 21 studies were eligible. Studies were primarily conducted in the UK, the Netherlands and Australia. The identified barriers to patient reporting of ADRs (n = 15 studies) included poor awareness, confusion about who should report the ADR, difficulties with reporting procedures, lack of feedback on submitted reports, mailing costs, ADRs resolved and prior negative reporting experiences. The identified motives for patients reporting ADRs (n = 10 studies) were: preventing others from having similar ADRs, wanting personal feedback, improving medication safety, informing regulatory agencies, improving HCP practices, responding to HCPs not reporting their ADRs and having been asked to report ADRs by HCPs. CONCLUSIONS: Most patients were not aware of reporting systems and others were confused about reporting. Patients were mainly motivated to make their ADRs known to prevent similar suffering in other patients. By increasing patient familiarity and providing clear reporting processes, reporting systems could better achieve patient reporting of ADRs.