Suffering from drug-alert overload
Posted on 30 May 2012 by Flora Tristan
You can see the lawyers will have a field day. Someone in the local politburo, or the health authority clearly doesn’t think GPs have enough to do, and has decided to copy us in, generously, to all the drug alerts.
Previously we used to get the big alerts. And we got them, reasonably enough, via more than one pathway: letters to every GP in the country from the drug companies, and the government, and the health authority pharmacy adviser and the safety regulator and the cluster pharmacist and then the practice pharmacist too.
And that was absolutely fine — we had to know about the hazards found to have been associated with these drugs and drug groups; we had to change our prescribing behaviour substantially; and we had to be able to inform and reassure patients.
I can’t say I actually enjoyed having to write to all the patients on a certain drug to invite them to contact us for review, but it was at least reasonable that I should have to. But now some switch has been flipped and we get every single drug alert in the country, and usually at least four times.
A small drug manufacturer at the other end of the country has managed to put four vials of drug A into a box labelled drug B. Mould has been noted on tablets C as they are being administered in a nursing home somewhere — and the batch numbers are given.
Tests on one manufacturer’s recent batch of a very widely used drug have shown ‘harmful substance’ — yes, batch numbers again and ‘staff should check all patients’ own stocks’.
Not only do we have these messages in quadruplicate over several days, with the inevitable result that we just don’t take much notice at all; not only do these shoals of messages and hyperlinks fill up inboxes and take up precious admin time and energy; not only are 90 per cent of these alerts utterly irrelevant to Innercitysville or primary care anywhere; there is also no clear chain of clinical command for response or action.
The advice is vague in the extreme and often utterly impossible to follow anyway – how can we check all patients’ stocks?
We raise this with the politburo, and are told ‘it’s just so the GPs can be aware’. Ah yes, ‘doctor aware’, the phrase beloved of the buckpasser.
The lawyers will love this. ‘Mrs X sadly passed away some five years ago now, m’lud, in 2012. She had been taking drug Z, and Dr Tristan was well aware that it might contain noxious, I may say POISONOUS, substances … GP did nothing … Tragic death…’
Just one more thing to worry about.
Flora Tristan, inner-city GP