by clicking the arrows at the side of the page, or by using the toolbar.
by clicking anywhere on the page.
by dragging the page around when zoomed in.
by clicking anywhere on the page when zoomed in.
web sites or send emails by clicking on hyperlinks.
Email this page to a friend
Search this issue
Index - jump to page or section
Archive - view past issues
Australian Journal of Pharmacy : July 2005
shpa N adverse drug reaction (ADR) is defined by the World Health Orga- nization as a ‘response to a medicine that is noxious and unintended and that occurs at doses normally used in humans’. When discussing ADRs, two facts should be kept in mind. First, a rel- atively recent review of hospital admis- sions found that only 11 to 31 per cent of ADRs were reported formally.1 A Second, the formal reporting of ADRs to the Adverse Drug Reactions Advisory Com- mittee (ADRAC) has played a significant international role in identifying previ- ously unsuspected ADRs, including hepatitis with some penicillins. As a post- marketing surveillance tool, ADR report- ing is critical. In Australia the monitoring of ADRS is coordinated by ADRAC with approxi- mately 30 per cent of all ADR reports being submitted by pharmacists. Within the subset of ADRs originating in hospitals the percentage is even higher with 75 per cent of reports being submitted by phar- macists. The high reporting rates by hos- pital pharmacists is perhaps not surprising as adverse drug reaction reporting is one of the services identified within the raft of activities defining clinical pharmacy. A recent paper by Nita, Batty and Plum- ridge looked at the attitude of hospital pharmacists and doctors to ADR report- ing.2 The study showed that pharmacists were more likely to report a relevant ADR (6.6 out of a possible 10) than doctors (5.2 out of a possible 10) The survey was conducted between June and September 2001 with question- naires sent to all Society of Hospital Phar- macist of Australia (SHPA) members, non- members in Western Australia and 803 doctors in five hospitals in Western Aus- tralia, including tertiary teaching, regional and secondary hospitals. The questionnaire was self-adminis- tered and anonymous and circulated by mail with a pre-paid return envelope. The anonymous study design precluded a fol- low-up to non-responders. The response 98 per cent of pharmacists knew how to report an ADR, only 57 per cent of doc- tors were similarly aware. Pharmacists were also more likely to support screening of ADR reports before submission to ADRAC (80 per cent versus 68 per cent). In addition to general information ques- tions and specific questions on the mechanics of adverse drug reaction reporting, the questionnaire also posed 15 hypothetical ADRs where respondents were asked to indicate which they would report. (Ten of the hypothetical ADRs should have been reported to ADRAC.) The study showed that pharmacists were more likely to report a relevant ADR (6.6 out of a possible 10) than doctors (5.2 out of a possible 10). While these results are gratifying with regards to the involvement and knowl- edge of hospital pharmacists, further work is required to reduce the barriers to ADR 518 ? THE AUSTRALIAN JOURNAL OF PHARMACY VOL.86 JULY 2005 hospital talk John Low, hospital pharmacist Adverse drug reactions—critical in post-marketing surveillance rate from doctors and pharmacists were 35 per cent and 43 per cent respectively. A number of exclusion criteria, including pharmacists no longer working in hospi- tal, resulted in valid responses being received from approximately 22 per cent (465/2,093) of Australian hospital phar- macists. Results of the study showed that while reporting, thereby improving both the quality and quantity of post-marketing surveillance data in Australia. Improve- ment of such data is an important driver to manage drug-related problems. One suggestion from the authors was an appropriately resourced team approach to raise awareness of the problem. While the identification of ADRs is important, managing them and prevent- ing them are, of course, equally critical. A recent study undertaken in Western Aus- tralia gives little cause for complacency where the authors reported the rate of ADR-related hospital stays increased from 2.5 per 1,000 person years in 1981 to 12.9 per 1,000 person years in 2002, with the largest increase observed in the most vul- nerable of our patients, those aged 80 and older.3 The authors noted ‘...the most com- mon drug group was cardiovascular agents (17.5 per cent) while anticoagu- lants (7.5 per cent) cytotoxics (7.5 per cent) and antirheumatics (6.8 per cent) were the more specific drug classes most com- monly implicated...’. Most worrying was the fact that ADRs from the last three classes mentioned were still rising at the end of the study in 2002. Obviously there is still much to be done to improve ADR reporting and to manage the consequences. Pharmacists from all practice areas well placed to make a major contribution. 1. Roughead EE. The nature and extent of drug- related hospitalisations in Australia. J Qual Clin Pract 1999;19:19–22. 2. Nita Y, Batty KT, Plumridge RJ. Adverse drug rations reporting: attitudes of Australian hospital pharmacists and doctors. J Pharm Pract Res 2005;35:9–14. 3 Burgess CL, D’Arcy C, Holman J, Satti AG. Adverse drug reactions in older Australians. MJA 2005;182:267–70. ¦