Intensive Hospital Monitoring of Adverse Reactions to Drugs

1 Seven thousand five hundred and twenty-six prescriptions written for eight hundred and forty patients in three hospital wards have been analysed for errors of drug use and errors of prescription writing. 2 According to the criteria adopted for this survey, more than 3% of prescriptions contained an error of drug use and more than 30% an error of prescription writing. 3 The incidence of adverse drug reactions, overdosage and undertreatment might be reduced by more careful prescribing.

Section: Introductionmentioning

confidence: 99%

Errors of drug prescribing.

Tesh¹,

Beeley²

1975

“…Adverse drug reactions have been shown to be a major cause of morbidity (Hurwitz & Wade, 1969;Miller, 1974). Nevertheless, in all studies the diagnosis of the reactions is usually based on common sense clinical judgement.…”

Section: Discussionmentioning

confidence: 99%

Comparison of two recently published algorithms for assessing the probability of adverse drug reactions.

Busto¹,

Naranjo²,

Sellers³

1982

1 A simple valid and reliable method for estimating the probability of adverse drug reactions (adverse drug reactions probability scale, APS) has been recently described (Naranjo et al., 1981a). 2 The results using APS were compared to those obtained with another more detailed algorithm (adverse reactions scoring system, ASS) described by Kramer et al. (1979). 3 Sixty-three randomly selected adverse drug reactions (ADRs) were rated by two observers, using APS and ASS one year apart. The cases were ordered in a random sequence. Between-raters reliability using APS (R(est) = 0.96 and ASS (R(est) = 0.86), was very high. 4 ADR scores obtained with both methods were highly correlated (r = 0.82, P < 0.001). However, time spent using ASS was significantly longer (paired t-test, t = 1.70, P < 0.05). 5 These results suggest that while ASS is somewhat more complex than APS both are equally reliable and will give very similar conclusions regarding the probability of ADRs. Such algorithms must be used if the clinical assessment of ADRs is to become acceptably reliable.

“…Estimates of morbidity due to digoxin and related glycosides vary, but are unacceptably high (Beller et al, 1971;Carruthers, Kelly & McDevitt, 1974;Hurwitz & Wade, 1969;Van Capeller, Copeland & Stern, 1959). Surveys carried out on digitalized patients recently admitted to hospital (Beller et al, 1971;Carruthers et al, 1974) reveal that digoxin toxicity is not confined to hospitalized patients and the implication is that the problem might be as prevalent amongst those receiving the drug in the community at large.…”

Section: Discussionmentioning

confidence: 99%

Digoxin measurements in general practice.

Holt¹,

Williamson²

1977

1 As part of a prospective study on the use of digoxin in a general practice, plasma digoxin concentrations were measured in all patients receiving the drug. 2 A low mean plasma digoxin concentration was observed, suggesting a cautious approach to digitalization. 3 The correlation between plasma digoxin concentration and signs or symptoms commonly used in the assessment of digoxin effect was poor. 4 It was concluded that the measurement of plasma digoxin could be of assistance in a variety of clinical settings within a general practice.