From Dr H. S. Boardman, FFPM
SIR,—In the course of following up a group of serious adverse events for a major drug company, events which pointed to a potentially serious new adverse drug interaction, I found myself talking to the drug information pharmacist of a large teaching hospital.
The consultant physician who had observed the event had made an inquiry about its possible relationship to the drug via the hospital's drug informationdepartment. In this way the company had come to hear of it.
That same physician, having benefited from the company's knowledge, had not filled in the adverse event forms sent to the pharmacist and forwarded on to him.
Could I be told the name of the consultant in question so that I could follow up the report directly ? "Certainly not," replied the pharmacist. "That would he a breach of my inquirer's confidentiality."
This view was confirmed by her line manager who, none the less, agreed with me it was an odd state of affairs and promised to take up the matter with the physician in question.
As a result the proper investigation of a potentially life threatening adverse drug interaction was obstructed by the "duty of confidentiality" owed by a hospital drug information pharmacist to a hospital consultant physician.
Who was the pharmacist's "duty of confidentiality" protecting? The public? The patients taking the drugs in question? Or the lazy physician who could not be bothered to fill in a form to help a pharmaceutical company improve the risk:benefit ratio of a drug?
Such problems are encountered daily by those of us working in drug safety and pharmacovigilance. Many important adverse drug reactions are reported at second hand by hospital drug information pharmacists and never followed up properly for the reasons outlined above. Clearly, it is time the "duty of confidentiality" owed by a hospital drug information pharmacist to a hospital doctor was replaced by a duty to "ensure that adverse drug events are reported promptly and properly to all interested parties".
Hugh Boardman
London SW20