The likelihood of adverse drug reactions are on the rise as people are living longer and taking more medications during the course of their lifetimes. In an editorial article in the April 17 issue of the New England Journal of Medicine, William Tierney, M.D., professor of medicine at the Indiana University School of Medicine and a research scientist at the Regenstrief Institute Inc., discussed the issue of adverse drug reactions and ways in which to decrease their frequency. The editorial accompanied a study conducted by the Boston's Brigham and Woman's Hospital (discussed in the previous SAA web site News Item).

Dr. Tierney said that reducing the number and severity of adverse drug reactions would require "vigilance and cooperation of doctors, pharmacists, and other health care providers." He believes that they need to be looking for and asking about such problems on a regular basis -- "Using electronic medical record systems can help this happen by reminding the providers which drugs a patient is taking and which side effects to look out for. Such systems can also improve communication between various health care providers."

Not all of the "bad" side effects of medication are actually due to the medication itself, he claims. In regards to adverse (side) effects found in the study at the Boston Brigham and Woman's Hospital, the effects were "often non-specific problems such as weakness, fatigue, and upset stomach. It is also unclear at times whether adverse effects attributed to drugs are due to the drugs themselves or the conditions they are treating." For example, drug side effects are more common in older people and in those with several chronic conditions who take multiple medications, according to Dr. Tierney.

In the editorial, Dr. Tierney called for broader studies based on more timely data of drug reactions. Oftentimes, studies of medication errors and their side effects focus on errors of commission (the drugs prescribed) instead of errors of omission (missed opportunities to prescribe appropriate medications). And he encouraged regular screening of patients for potential drug-related symptoms, and using computer-based medical records systems which can potentially eliminate preventable errors caused by illegible handwriting, inappropriate dosing, known drug interactions, and allergies.