The Pharmaceutical Journal
Vol 274 No 7334 p104
29 January 2005

This article
Reprint   Photocopy

  Acrobat Reader

News summary

Medicine-related symptoms fail to be addressed

Doctors fail to address up to a quarter of medicine-related symptoms reported by patients, according to US researchers.

Saul Weingart, Beth Israel Deaconess medical centre, Boston, Massachusetts, and colleagues interviewed 661 patients and reviewed their medical records to establish how many adverse drug reactions (ADRs) the patients experienced over a three-month period. Where adverse reactions relating to prescribed medicines were identified, the researchers also questioned the patients’ doctors to find out how the events were dealt with.

The researchers found that although many patients experienced ADRs (179 patients identified 286 medicine-related symptoms), they failed to report 31 per cent of them to their doctors. This failure to discuss medicine-related symptoms resulted in 21 adverse reactions (23 per cent) — 19 of which could have been ameliorated and two of which could have been prevented.

Doctors made changes to patients’ therapies in response to 76 per cent of reported symptoms. However, their decision not to change therapy in 48 cases resulted in 31 adverse reactions (65 per cent).

“ For every symptom that patients experienced but failed to report, one in five resulted in an adverse drug event that could have been prevented or been made less severe,” Dr Weingart commented. “For every symptom that patients did report but doctors failed to act on, two thirds resulted in an adverse drug event,” he continued.
The researchers observed that patients discussed fatigue, gastrointestinal problems, sexual problems and mood changes more often than headache and incontinence.

In addition, patients who took multiple medicines and who had drug-related allergies were more likely to discuss symptoms with their doctor.

Doctors were more likely to make changes to patients’ therapy if they reported muscular aches, problems with sleep, gastrointestinal problems and rash or itching than if they reported fatigue and sexual problems.

“ Patients have a lot to tell us about symptoms they experience due to their medications,” Dr Weingart said, adding that by asking questions regularly and taking patients’ comments seriously there is an opportunity to prevent harm. The study is published in Archives of Internal Medicine (2005;165:234).