Adverse drug reactions: managing the risk

Area of Science:

• Clinical Pharmacy
• Mental Health Nursing
• Health Informatics

Background:

• Medication management and monitoring are critical concerns in patient care.
• Patients in mental health services are particularly vulnerable to iatrogenic risks from adverse drug reactions.
• Physical health monitoring is essential for individuals receiving mental health treatment.

Purpose of the Study:

• To evaluate the necessity of formalizing medication monitoring within electronic health records.
• To assess current electronic record-keeping practices in two UK crisis resolution home treatment (CRHT) teams.
• To identify deficiencies in monitoring for adverse drug reactions in electronic versus paper records.

Main Methods:

• A review of electronic records for all clients in two CRHT teams was conducted.
• The study examined records for evidence of monitoring potential adverse drug reactions.
• Findings were benchmarked against a national audit sample of paper records.

Main Results:

• Electronic records demonstrated significant omissions in medication monitoring, including blood pressure (14/57), heart rate (15/57), and weight (13/57).
• Paper records from the teams outperformed electronic records and a national audit sample in recording blood pressure and obesity.
• Minimal differences were observed between the two CRHT teams studied.

Conclusions:

• Electronic record formats require modification to adequately document adverse drug reactions and physical health.
• Careful management of the transition to electronic records is crucial for including adverse drug reaction data.
• The West Wales Adverse Drug Reaction profile (version II) is proposed as a strategy for improving monitoring in mental health settings.