BAD DRUG REACTIONS RIFE IN AUSTRALIAN PATIENTS

At eight per cent of those consultations, patients inform their GP they have been hospitalised as a result of medicine side-effects.

The research, by Associate Professor Graeme Miller and colleagues at the Australian General Practice Statistics and Classification Centre, revealed GPs consider almost half the reactions suffered to be moderate or severe, but believe 23.2 per cent of all reactions are preventable.

"One in ten patients presenting to a GP has had an ADE (adverse drug event) in the preceding six months, almost 50 per cent in the moderate to severe range," Assoc Prof Miller said.

"The level of morbidity (illness) revealed in our study places ADEs as one of the most important causes of morbidity in the Australian community.

"Moreover, as this was a study of patients attending general practice, the most severe result of ADEs, namely death, was not included."

Assoc Prof Miller said the research demonstrated current reporting requirements were inadequate.

"To prevent 'overload', statutory reporting authorities actively discourage reporting of less severe ADEs and those due to known side effects of drugs," he explained.

"Many ADEs are therefore classified as unimportant by the health system and remain a largely hidden source of patient morbidity."

Tighter reporting and regulation and an improved culture of safety would help reduce the number of adverse reactions, Associate Professors Elizabeth Roughead and Joel Lexchin said, in an editorial in the same issue of the Medical Journal of Australia.

Assoc Prof Roughead is at the School of Pharmacy and Medical Sciences, University of South Australia, and Assoc Prof Lexchin is at the School of Health Policy and Management, York University, Toronto, Canada.

"We need a no-blame culture, supporting safer systems in practice as well as incident monitoring, with timely feedback to practitioners and consumers," Assoc Prof Roughead said.

"It is health professionals, in consultation with patients, who must identify ADEs in practice.

"Therefore, computerised systems should alert GPs when patients receive new prescriptions and identify all medications they are receiving from any provider.

"Knowledge of what their patients are taking can help GPs flag which of their patients are at high risk."

More vigilant and comprehensive drug studies also would reduce the number of adverse reactions suffered in the general community, she said.

"We need systems that can deal with the reality that only limited numbers of highly selected patients are studied before a drug is marketed," Assoc Prof Roughead said.

"Regulators may have to consider restricting prescribing of new medications if they have limited safety information, particularly when equally efficacious therapy is available.

"New systems for detecting early signals of potential adverse drug reactions in expanded populations could complement the current reporting system for adverse drug reactions."

The Medical Journal of Australia is a publication of the Australian Medical Association.