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Adverse Drug Reactions On the Rise: What You Can Do to Shield Yourself from the Dangers of ADRs

Adverse reactions to prescription drugs are occurring at alarming rates in U.S. hospitals and elsewhere. It was known back in 1994 that over 2.2 million hospital patients had serious adverse drug reactions (ADRs). That same year, 106,000 patients died from an adverse reaction to a drug.

adverse drug reactions

Before swallowing your next pill, read the steps at the end of this article to reduce your adverse drug reaction risk.

In the Journal of the American Medical Association, which published these results, researchers said, "The incidence of serious and fatal adverse drug reactions in US hospitals was found to be extremely high." That was in 1998. Today, ADRs are still on the rise.

In 1992, there was one adverse drug reaction per every 16,300 prescriptions, according to a study by Knight-Ridder. By 2003, the ratio had grown to one in 9,000.

Adverse Drug Reactions One of the Leading Causes of Death

The JAMA study reported that, in 1994, adverse drug reactions were between the fourth and sixth leading cause of death in the United States.

More recently, a study published in the New England Journal of Medicine found that one in four patients is plagued by side effects from prescription medications.

"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, lead author of the study and an internist at Brigham & Women's Hospital in Boston.

Of the patients who experienced side effects (out of over 1,200 patients), 13 percent were serious (internal bleeding, low blood pressure, etc.). Another 39 percent were preventable or potentially treatable, such as a patient accidentally receiving a drug he or she is allergic to.

In an editorial about the study, William Tierney of the Indiana University School of Medicine said, "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."

Out of the cases that were preventable:

  • Patients were given the wrong drug 45 percent of the time.

  • Patients were prescribed the wrong dose 10 percent of the time.

  • Patients were told to take the drug too frequently 10 percent of the time.

If measures aren't taken to keep mistakes like these from happening, Tierney says the outlook is dim.

" ... Given the increasing number of powerful drugs available to care for the aging population, the problem will only get worse," he said.

Three drug classes appeared to present the greatest risk of side effects:

  • Serotonin-reuptake inhibitor class of antidepressants

  • Non-steroidal anti-inflammatory drugs (NSAIDs), often used for joint pain

  • Calcium-channel blockers, used to treat high blood pressure

Other studies have also found that adverse drug reactions represent a serious risk to Americans. Findings include:

  • An estimated 5 percent of hospital admissions -- over 1 million per year -- are due to drug side effects.

  • ADRs were directly responsible for the hospital admission 3.8 percent of the time, yet 57 percent of them were not recognized by the physician at the time of admission.

  • 18.6 percent of all drugs prescribed prior to hospital admission were contraindicated.

  • Up to 88 percent of ADR-related hospitalizations in the elderly are preventable.

  • Nursing home residents suffer 350,000 ADRs a year, according to the Institute of Medicine.

adverse drug reactions

Doctors are only human -- they do NOT have all potential drug interactions memorized. After asking your doctor about possible adverse drug reactions for a prescribed medication, double-check by asking your pharmacist.

Billions of Prescriptions, Reactions Not Reported

Over 3.3 billion prescriptions were given out in the United States in 2002. With all of these drugs being taken, it seems an obvious next step would be to implement a system to track any and all serious reactions to them.

There is such a system -- called MedWatch -- that's operated by the Food and Drug Administration (FDA). The problem is that reporting by doctors is voluntary, and only a small percentage of incidents are actually represented in the database, according to the FDA.

Meanwhile, many ADRs are never recognized for what they are, and the patient may instead be diagnosed with a new "disease."

According to Gandhi's study, in close to two-thirds of the cases side effects continued because doctors did not notice warning signs. In the remaining cases, symptoms persisted because the patients did not mention them to their doctors.

"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 ... With these 10-minute appointments, it's hard for the doctor to get into whether the symptoms are bothering the patients," Gandhi said.

Steps to Reduce Your Adverse Drug Reaction Risk

Ideally, the best way to reduce your risk of having an adverse reaction to a drug is to limit your exposure to them in the first place. This is something that can (and should) be done as a matter of course throughout your life by:

Sometimes, though, drugs are necessary and unavoidable. For these times, it is up to you to be an informed patient and proactively work with your doctor to help reduce your risk of ADR.

Doctors are human and do not always check for potential drug interactions, correct dosages or allergies -- so don't assume that this has been done. The next time you receive a prescription, take these steps to reduce your risk of ADR:

i. Be aware that you are at an increased risk of ADR if you are taking two or more medications (and an extremely increased risk if taking four or more).

ii. Make sure your doctor is aware of your medication history and drugs you are currently taking -- including vitamins, herbs and over-the-counter meds. If he or she doesn't ask (though they should), bring it up and tell them yourself!

iii. If you are taking multiple drugs, ask your doctor specifically: "Will this new medication interact with X, Y or Z?" (the medications you're already taking)

iv. Be aware that certain drug categories are especially risky in terms of interactions. These include:

a. Anticonvulsants

b. Antibiotics

c. Certain cardiac drugs such as digoxin, warfarin, and amiodarone

v. When picking up the prescription, check again with the pharmacist by asking if this drug interacts with any drug you are already taking, possible side effects, risks, etc.

vi. If you experience any unusual symptoms upon taking the medication, call your doctor immediately and explain the problem.

Recommended Reading

The Danger of Antacids and What You Should Do Instead

Do You Really Need a Multivitamin Supplement?


The Shreveport Times April 1, 2006

ContraCosta Times March 27, 2006

JAMA. 1998 Apr 15;279(15):1200-5

Medication Side Effects Strike 1 in 4

Center for Drug Evaluation and Research

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