An old but very important idea seems to have obtained a new lease on life!
Patient data could show medicines danger
Mark Metherell
January 3, 2009
THE national health safety agency is pressing the Federal Government to cross-check the huge bank of information held in the Medicare and pharmaceutical records of patients to curb thousands of avoidable illnesses and deaths caused every year by medication problems.
Harmful new drugs and lethal side effects would come to light much more quickly if Australia used "two of the richest health information stores in the world" - the Pharmaceutical Benefits Scheme and Medicare, according to the Australian Commission on Safety and Quality in Health Care.
The commission cites the rapid growth in use of new anti-inflammatory drugs in 2000 which were later found to be associated with a higher risk of death and side effects in diabetes and heart patients. One of the drugs, Vioxx, was linked with more than 1000 adverse events, about 30 per cent of which ended in deaths.
"Earlier recognition of this pattern of medicine use may have prevented adverse events in these high-risk groups," says the commission in a new report.
By linking patient details (from which personal information has been removed) from PBS and Medicare computers with death and disease records, "we would be able to identify problems with medications more quickly, identify previously unrecognised side effects, identify the risk of side effects in groups not included in the clinical trials [for new drugs], and assess the appropriateness of medication use in practice".
The commission calls for "national leadership" to support the development of a more integrated approach to exploit the information available.
The call comes in the commission's annual report Windows Into Safety And Quality In Health Care 2008, in which it makes the case for a more open and accountable approach to combat mistakes in surgery, medication and infection control.
More here:
The full report is found here:
Not much of this is new as can be seen from my blog of last month.
Tuesday, December 09, 2008
A Gap That Really Needs to be Filled (and Can Be Easily) here in Australia.
The following appeared a few days ago.
Drug safety watchdog to be replaced with new body
Julie-Anne Davies | December 06, 2008
Article from: The Australian
THE drug safety watchdog is to be abolished and a new committee with broader powers established in its place, under reforms planned by the Rudd Government.
The Weekend Australian has learned the Adverse Drug Reactions Advisory Committee will be replaced by a Medicines Safety Committee as part of an overhaul of the nation's drug safety system.
It is understood the Rudd Government will introduce a more vigilant drug safety regime that will include rigorous surveillance of prescription drugs after they have received approval to be sold in Australia.
A spokeswoman for the Therapeutic Goods Administration, which oversees drug safety in Australia, confirmed there were a "number of enhancements proposed to the pharmacovigilance framework for prescription medicines".
These will include the introduction of drug audits and the appointment of a drug monitor to oversee the safety of specific drugs.
The new drug safety committee will be given extra powers to oversee, assess and review risk-management plans of drug companies for approved medicines.
A more flexible protocol that will allow drugs to be suspended rather than withdrawn or recalled when safety issues arise is also expected to be in the legislative reform package slated to be introduced into federal parliament early next year.
The Weekend Australian earlier this year revealed chronic under-reporting by doctors and hospitals of serious adverse reactions to drugs could be creating a false picture of which medications pose a health threat.
Of the estimated 500,000 cases a year nationally of people becoming sick because of a drug they are taking, GPs report less than 2 per cent to the TGA.
More here:
http://www.theaustralian.news.com.au/story/0,25197,24758470-23289,00.html
All I can say is amen to that and to point out that if ever there was an area where e-Health and Data Mining can help this is it.
Medicare has access to huge amounts of medicines and clinical outcome information that could be mined – with the right controls – to make a huge difference. I hope discussion of doing something like this is on the top of the agenda of the new National E-Health Management body.
David.
End Blog.
What is a little sad is just how little apparent effort the Australian Commission on Safety and Quality in Health Care seems to be investing in causing these obviously useful outcomes to come about. As readers of this blog will know only too well quality and safety of care are both a key stimulus to broader use of Health IT and one of the few evidence based ways to actually achieve major improvements.
It is well past time the Australian Commission on Safety and Quality in Health Care pushed a good deal harder on this button in my view.
David.
1 comment:
At this stage in OZ, Medicare maintains an electronic patient record only of PBS listed medication for which the Commonwealth co-payed some part on the patient's behalf. If there is no co-payment - no electronic record is maintained by Medicare.
Is a part electronic record of medication being consumed by the patient adequate to commit monitoring resources by the Commonwealth to counteract potential adverse outcomes?
There is overwhelming evidence (in my view) to make a case for the absolute recording of consumed medication based on the widely circulated estimates of adverse reaction outcomes.
There are many well documented adverse reactions between prescribed or over the counter medication with apparent non medication consumption but the majority of adverse and cost negative reactions is with prescribed and OTC medication.
Consequently, health practitioners should lobby for the Commonwealth maintenance of an electronic patient record based on common health provider sources.
This is especially relevant where the taxpayer is expected to foot the bill as a result of an adverse reaction.
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