We need to pay better attention to medication side effects|Marlene Beggelman, MD | Meds | February 22, 2017
Clinicians often misdiagnose problems caused by medications, especially when patients take multi-drug combinations.
In a study a few years ago, when patients told their doctors they had symptoms that are widely known reactions to the drugs they were taking, almost half the doctors told them there was no connection.
A typical report: the “doctor suggested it was (my) imagination” or that “it’s all in my head.”
It’s comforting to hear this is so common for many medications because this is exactly what has happened to me several times in the past.
There are various reasons that drug side effects might go unrecognized:
- the shrinking time physicians have to spend with patients;
- the fact that doctors receive lots of information about the benefits of drugs but not much on their dangers; and
- cognitive dissonance or denial about the negative effects that drugs can have.
But when doctors fail to connect symptoms to medications, not only do they fail to help their patients, but they also fail to report the side effects to the Food and Drug Administration.
As a result, the FDA is likely underestimating the reactions, leading other doctors and patients to believe some drugs are safer than they are.
In fact, a high percentage of serious reactions have never even been investigated.
Since drug reactions are often the cause of even the most frequent symptoms (such as fatigue, achiness, depression and cognitive dysfunction), medications should always be considered as a potential cause.
Patients may be the most reliable sources to report side effects. In fact, they are often the only information source about reactions to medications. Their observations deserve serious consideration.
Federal money for drug research and safety has declined to the point that pharmaceutical companies now fund over 85 percent of all research, medical journal publications and medical conferences, where physicians receive much of their educational information –- a clear case of the fox guarding the chicken coop.
Pharmacists have an important role to play here too, and could be the point of contact where FDA reporting is initiated. It’s easy to imagine a sign at the pharmacy counter that says, “Ask me about side effects.”
It may also be time to expand our vision about how drug-safety research can be conducted.
Social media provides a rich source of data, with hundreds of thousands of internet users communicating with each other monthly about their medication-related experiences.
This “big data” source offers the massive number of data points required to understand the safety of multi-drug combinations — something that we currently know very little about.
Almost three-fifths of Americans take a prescription medication, and nearly 15 percent take five or more, while children are the fastest growing market for drug companies.
With drug reactions already the third-leading cause of hospital deaths in the U.S., we desperately need more focused, sustained and unbiased research and education to put the brakes on what is already an epidemic of medication-driven catastrophes.
Author: Marlene Beggelman is an internal medicine physician and a member, Right Care Alliance. This article originally appeared in WBUR’s CommonHealth.
‘Adverse Event,’ Not the Same as ‘Side Effect’ | Shelby Leheny, BS, PharmD Candidate 2017 | Feb 21, 2017
An adverse event is an undesired occurrence that results from taking a medication correctly.
The event can either be a type A reaction or a type B reaction.
Type A reactions are predictable adverse events which are commonly dose dependent and can be mild, moderate, or severe.
Type B reactions are completely unpredictable and have nothing to do with doses. They occur less often and are influenced by patient-specific susceptibility factors such as drug allergies and intolerances.
A patient may experience an adverse event due to the healthcare provider’s lack of knowledge of the drug and the medications complete mechanism.
The event is not expected by either the doctor or the patient and the effects can be reduced by lowering the dose or just stopping the medication all together.
A side effect is an undesired effect that occurs when the medication is administered regardless of the dose.
Unlike adverse events, side effects are mostly foreseen by the physician and the patient is told to be aware of the effects that could happen while on the therapy.
Side effects differ from adverse events and later resolve on their own with time after taking the medication for several weeks.
Some medications are even utilized due to their side effects, one example being mirtazapine used in anorexic patients due to the medications potential to cause weight gain. Side effects are tracked and investigated extensively during clinical trials before entering the market.
Adverse events are different from side effects and are never desired.
Adverse events require interventions whereas most side effects spontaneously resolve with time.
The 2 words are incorrectly used interchangeably yet mean 2 separate things. Although this may seem like common sense to some, the incorrect use of these 2 words appears to be a common mistake within the healthcare field.