Adverse Drug Reaction

An adverse drug reaction (ADR) is an unexpected, unintended, undesired, or excessive response to a medicine that 1) requires discontinuing the medicine or changing the medication therapy, or modifying the dose (except in minor dose adjustments), 2) necessitates admission to a hospital, or supportive treatment, prolongs stay in a health care facility (HCF), 3) significantly complicates diagnosis, or negatively affects prognosis, and finally, 4) results in temporary or permanent harm, disability, or death.

The frail elderly are at a significant higher risk of developing ADR from medications. However, reporting ADR in the elderly remains a challenge because of their underlying medical conditions.

How are ADR reported in your facility? Is there a policy that is comprehensive, and easy to use? How often is it being used? Is the consultant pharmacist responsible for ensuring an overall education of the staff regarding ADR? Furthermore, is suspected ADR reported and investigated and discussed?

A staff member or a single member of the interdisciplinary team should not shoulder the burden of establishing an ADR; suspected ADR should be reported, and then investigated by a committee. The committee will then rule-in or rule-out the particular ADR. The cascade that may ensue from misattributed ADR on the disease management should not be underestimated.