Adverse Drug Reaction [ADR] programme needs trained ADR pharmacists and there is a need to have an in-house Drug Information Centre [DIC] in every medical establishment country, said Graeme Vernon, senior drug information, Austin & Repatriation Medical Centre, Australia who was in Bangalore for a one-day seminar organised by the Karnataka State Pharmacy Council on 'Drug Information and Adverse Drug Reaction Monitoring'. He also called for a separate cell in ADR for alternative medicine, which is fast catching up world wide.
Dr. Vernon highlighted the facility of the DIC in Australia. He said the 24-hour facility provides protocols, guidelines through electronic distribution connected through the Australian Network. The queries related are on ADR, efficacy and treatment of drugs, dosage forms etc. "There are several instances of drug reactions in Chinese herbal medicines which is popular in Australia, and hence needs a close monitoring of such herbal drugs," he said.
The government of Australia has gone on to subsidise the telecom rates to facilitate cost effective access for people in the country to have a first hand information on ADR which is critical in healthcare, he noted. There will also be a National Consumer Service being set up in Brisbane with two dedicated phone lines for DIC to be able to discharge its services.
The government of Australia has also maintained a Register of Imported Drugs as the country has a large tourist population and there are number of instances where such drugs brought by them are found to have adverse reactions among the visitors during their stay in Australia, he informed.
According to Vernon, drug information is a combination of resources, training and experience. "It takes a year to train pharmacists in ADR. There is a need for web-based resource centres catering clinical information and DIC needs resources like primary literature, WHO [World Health Organisation] Inter Network project and access to journals where original research is published about drugs," he added.
The training programme for ADR covers search skills on web, understanding of available resources, critical appreciation of evidence, clinical judgement, learning from experience and peer review.
The DIC at the Austin & Repatriation Medical Centre, Australia is working with Indian centres in Bangalore, Mysore and Udhagamandalam in Tamil Nadu. In India, there were different diseases and several drugs for each ailment. He quoted the instance of getting an enquiry on rifampicin used for the treatment of leprosy, a disease which he had only heard and never witnessed a case.
ADR is a disturbing issue, which must be tackled by medical and pharma professionals. World wide too ADR is responsible for a number of hospital admissions and even cases reported during their hospital stays.
The ADR programme calls for reporting cases, documentation, indication of warning labels and cards. It is also important to record the severity of reactions for each drug with a warning card.
The ADR report should document all drugs administered to the patient prior to an incidence of a reaction, treatment administered for the countering the reaction, its outcome and additional information like details of drug therapy to reaction, feedback on the current Drug Therapy Chart and clinical alerts, said Vernon.
The main benefits of ADR are that patients who experience a reaction if diagnosed in advance, then the future patients would benefit from information learned from the past. Apart from efficient-economical drug use, minimized organizational liability, ADR also helps in reducing hospitalization, Vernon said.