From Mr D. E. Hands, MRPharmS, and Miss E. Grant, MRPharmS
SIR,—We write, as drug information pharmacists, in response to Dr Boardman (PJ, January 29, p182), who proposes that the "duty of confidentiality" owed to a hospital doctor asking about possible adverse reactions is replaced by a duty to "ensure that adverse drug events are reported promptly and properly to all interested parties".
We would point out that drug information pharmacists already do a great deal to ensure that adverse drug events are reported. Any adverse event forms sent by a pharmaceutical company, which has been contacted for information about a possible adverse reaction, are automatically forwarded to the doctor concerned. In addition, drug information and other pharmacists go to great lengths to encourage doctors to complete such forms, or to complete a Committee on Safety of Medicines yellow card or both. Many drug information centres also act as local or regional co-ordinating centres for adverse reaction reporting schemes.
The UK Drug Information Manual, checked by the Royal Pharmaceutical Society, (Section 3.8.3) states that "the identity of the inquirer should be withheld from a third party (eg, clinical expert or pharmaceutical company) unless specific approval is obtained from the inquirer".
Doctors and other health care professionals contact drug information services in the knowledge that their inquiry, whatever its nature, will be treated as confidential. If such promised confidentiality is broken, it is likely that inquirers will no longer trust drug information pharmacists and cease to use the service. Future inquiries about adverse effects of drugs could remain unasked, to the detriment of our future knowledge of such reactions and patient safety.
We agree with Dr Boardman that we all need to do all we can to report adverse events to drugs, and particularly those of a serious nature. Breaking an inquirer's confidentiality is not the best way to achieve this.
David Hands
Fareham, Hampshire
Elena Grant
Sutton Coldfield, West Midlands