- BOSTON (Reuters) - Side effects
from prescription medicines plague one in four patients, and when they
surface, most doctors fail to act, U.S. researchers said on Wednesday.
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- The findings, from a study published in this week's New
England Journal of Medicine, sound an alarm to the millions of Americans
who take prescription drugs each year. Some 3.34 billion prescriptions
were dispensed in the United States in 2002, according to IMS Health, a
provider of pharmaceutical and health care data.
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- "It's a problem that is common, in many cases the
impact could be prevented or reduced, and it has a large impact on patients,"
said Tejal Gandhi, an internist at Brigham & Women's Hospital in Boston
and the chief author of the study.
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- Previous estimates have suggested that nearly 5 percent
of hospital admissions -- over 1 million per year -- are as a result of
drug side effects. But most of the cases are not documented.
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- The findings of the Gandhi team are based on prescriptions
given to 1,202 adults in four outpatient clinics in Boston.
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- "They found that adverse drug events were fairly
frequent and usually mild, although potentially serious, and preventable
events were more frequent than any patient or clinician would like (or
should be willing to accept)," William Tierney of the Indiana University
School of Medicine said in an editorial.
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- Among the side effects, 13 percent were serious, such
as low blood pressure or internal bleeding, and 39 percent were preventable
or potentially treatable, such as cases where a drug was given to a patient
known to be allergic to it.
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- In preventable cases, patients were given the wrong drug
45 percent of the time, the wrong dose was prescribed in 10 percent of
the cases, and patients were told to take it too frequently 10 percent
of the time.
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- "A lot of problems were going on a long time that
weren't being fixed, either because the patients didn't tell the doctor
or the physicians didn't change the medication. That was what surprised
us," Gandhi told Reuters.
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- In nearly two-thirds of the cases, the side effects persisted
because the doctor failed to heed the warning signs. Patients who suffered
in the remaining cases did so because they never told the doctor about
their symptoms.
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- Gandhi said the problem is important, in part, because
side effects may discourage patients from taking vital medicines, potentially
worsening their health.
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- Tierney said the medical community needs to use a variety
of techniques to reduce side effects, such as computer programs that check
doses or a system where patients are routinely interviewed about possible
drug-related symptoms while they wait for their appointment.
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- "With these 10-minute appointments, it's hard for
the doctor to get into whether the symptoms are bothering the patients,"
Gandhi said.
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- "In the absences of such efforts ... given the increasing
number of powerful drugs available to care for the aging population, the
problem will only get worse," Tierney said.
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- The drugs that posed the greatest risk of side effects
were the serotonin-reuptake inhibitor class of antidepressants, the non-steroidal
anti-inflammatory drugs often given for joint pain, and calcium-channel
blockers used to treat high blood pressure.
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- Copyright 2003 Reuters Limited.
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