The “What I Wish I Knew” series of articles is a service of AAPP’s Resident and New Practitioner Committee. Articles are intended to provide advice from experts for students, residents, and new practitioners. Articles are not intended to provide in-depth disease state or pharmacotherapy information nor replace any peer-reviewed educational materials. We hope you benefit from this “field guide” discussing approaches to unique problems and situations.
Matthew A. Fuller, Pharm.D, FASHP, BCPP
National PBM Clinical Pharmacy Program Manager
VHA Pharmacy Benefits Management Services (12PBM)
US Department of Veterans Affairs
Clinical Professor of Psychiatry and Psychology
Case Western Reserve University School of Medicine, Cleveland OH
Adjunct Associate Professor of Clinical Pharmacy
University of Toledo School of Pharmacy, Toledo OH
Dr. Fuller has over 40 years of experience as a pharmacist. Currently his work focuses on formulary management for the Veterans Health Administration. When in practice, his primary practice site was an acute inpatient psychiatry unit where he also served as the Residency Program Director for an ASHP accredited PGY2 Psychiatric Pharmacy Residency Program. He is a Past President of the College of Psychiatric and Neurologic Pharmacists and a Past President of the College of Psychiatric and Neurologic Pharmacists Foundation. He remains active in scholarly pursuits with research and publication, has presented at local, state, national and international venues and serves as a reviewer for multiple psychiatric and pharmacy journals. He has notably served as a member of the Editorial Board Panel on Psychiatry for The Annals of Pharmacotherapy as well as Lexi-Comp’s editorial advisory panel. His personal interests in research and clinical practice include novel strategies for the management of schizophrenia and mood disorders.
Make sure you have the facts and details correct and that you establish the sequence for the events that you want to report. The facts may include the nature and time course of the event, demographic information, laboratory data, medications and disease states.
Why are you thinking about publishing a case report? Generally, because what you are seeing in your patient(s) clinically does not support what you know/is known about a drug or drugs (remember to consider drug-drug interactions as a possibility). You also want to add to the medical literature so that other health care professionals are able to learn from your information and potentially spur ideas for conducting research.
Is what you are describing unique? Search the medical literature and the drug’s package insert to determine if what you want to report is unique. If there are previous case reports published, what makes your case different? You will need to acknowledge previous information and describe the differences in your case and what you are reporting. Is the sequence logical? Did you do a Naranjo probability test? Are the results supportive? Are there alternative explanations for what you are describing? If there are alternative explanations, this can diminish the publishability of your case. Use the discussion section of the report to rebut possible alternative explanations to support your assertion of causality. In other words, convince the reviewer and reader that what you are reporting is likely. Lastly, does your case report add to the medical literature? Will it be helpful to other health care professionals to know about it?
Review pharmacy and medical journals that publish material related to your case. For example, if you are reporting a new adverse reaction related to a mental health medication you may consider: The Mental Health Clinician or American Journal of Psychiatry. If you are not sure where to submit your case, consider using JANE (Journal/Author Name Estimator): http://jane.biosemantics.org/. Determine if the journal accepts case reports. If so, review their “Author Guidelines” on their website. Follow the guidelines closely, paying attention to word count, format, and any figure/reference guidelines. The following are generally necessary items for every journal: background, case report, discussion, conclusions, and references. If working with others, divide the work but be sure to discuss authorship prior to submission. Sometimes it is helpful to have a medical expert review your report for their input and edits. It will offer a review from another set of eyes and may fuel future collaboration. After submission to the journal the case report undergoes editorial review. Case reports are generally sent out to 2-4 individuals for external peer review. The reviewers may recommend acceptance with no revisions, acceptance with revision and review by the editor, acceptance with revision and re-reviewed by the external reviewers, or it may be rejected. If a revision is requested, address each comment specifically. If rejected, do not take it personally. Consider revising your report and resubmitting it to a different journal. Be persistent! The submission process may take 1-3 months and publication usually takes 6-12 months from initial submission.
