Posted by: Sophie Khatib2 DEC 2012
Yes, you read it right – are we getting the most out of our patients, or more accurately are patients getting the most out of other patients?
Let me explain myself!
As a pharmacy student, we are regularly reminded about those drugs in the BNF with ‘black triangle’ status. As you are all probably aware, those are the drugs that have been newly licensed and are in phase 4 clinical trials. It may also be that it is an older drug that has just been licensed for a new indication. This alerts us to the fact that greater surveillance is needed and that both healthcare professionals and patients need to be alert for any possible adverse events. This is all well and good but is it ok for us to step down our surveillance after the black triangle status has been removed?
We just need to think back over the last year for new clinical information that has emerged surrounding the use of older drugs. The new interaction between calcium channel blockers and high doses of statins and the newly published information regarding cardiac side effects of domperidone being two prime examples.
With polypharmacy seeming to increase every year, patients are taking new combinations of medicines with untested results. A lot of the ‘interactions’ that computer programmes alert us to are merely theoretical interactions but how much notice do we pay to these and what impact does that have on the patient? A lot of the time, we just don’t know.
The introduction of MURs and NMS schemes have helped to give patients the opportunity to talk about their medicines and any problems they are having with them, but are we targeting enough patients? Or the right types of patients? Is there a better way of obtaining such information from our patients in order to help other patients? Maybe there are; information slips under each item on a repeat prescription form, boxes for patients to put comments about their medicines (somewhat like a comments box), a dedicated telephone line to receive specific problems with any medication. I appreciate the presence of the yellow card scheme for reporting such events, but are patients and pharmacists aware enough to be able to utilise this to its best? I’m not totally convinced. Are pharmacists holding back on reporting seemingly minor side effects? Possibly. There may well be a better way to obtain information from our patients but where does it start?