The Pharmaceutical Journal
Vol 273 No 7307 p43
10 July 2004

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Pharmacists can reduce adverse reaction costs

Community and primary care trust pharmacists have a key role to play in helping to reduce the £466m a year cost to the NHS caused by adverse drug reactions, a pharmacist researcher claimed this week. However, more resources are needed to enable them to achieve this effectively.

Sally James’s comments follow publication last week of a study into the burden on the NHS of adverse drug reactions in which she was involved. The study reveals that 72 per cent of the ADRs identified were avoidable (BMJ 2004;329:15).

Miss James, a senior clinical pharmacist and medical admissions pharmacist at Wirral Hospitals NHS Trust, said: “We found that patients’ medicines were not being reviewed regularly enough. And although all health professionals, including GPs, have a responsibility to review medication, it would be good if we could see community pharmacists spending more time on this.”

She added that extra resources as well as access to patients’ notes would need to be forthcoming. “Hopefully, development of the electronic patient record may go some way towards helping this.”

Lack of patient information is often an obstacle to community pharmacists being able to identify potential adverse drug reactions, according to David Pruce, director of practice and quality improvement at the Royal Pharmaceutical Society.

He said: “Community pharmacists do not have access to the basic information about the patient’s diagnosis or vital test results that would help them to detect many adverse drug reactions before the patient could be harmed.” He maintained hospital pharmacists were in a much better position to detect adverse drug reactions because they often took prescribing decisions and had greater access to a patient’s clinical information.

This view was endorsed by the Pharmaceutical Services Negotiating Committee. Its chief executive Sue Sharpe said the Medicines Uses Review — proposed in the new community pharmacy contract as an advanced service — will allow accredited pharmacists to carry out a face-to-face medicines review with the patient and would help reduce adverse drug reactions in future.