Adverse drug reactions: current issues and strategies for prevention and management

Adverse drug reactions (ADRs) are common, frequently serious and cause considerable morbidity and mortality. In addition to human costs, ADRs place considerable economic burden on society and already-stretched healthcare systems. Much work has been done to determine potential causes, commonly responsible drugs and susceptible patient groups. To this end, various national pharmacovigilance schemes exist to collate information about ADRs. Despite this, levels of ADR reporting are universally poor, with ADRs remaining a significant clinical problem. Therefore, more effective dissemination and implementation of available knowledge is needed, together with better use of the systems already in place. Local ADR centres and teams, in close liaison with national centres, appear to be an important part of this process and need to be developed within healthcare systems. In addition, there is now evidence to suggest that better use of informatics will help to facilitate this, together with wider availability of electronic notes and greater use of computer-prescribing. Although advancing technology may help to make the use of medicines safer, more effective and more specific in the future, investment to develop informatics infrastructure and local ADR teams is now needed in our healthcare systems.