BMJ  2003;327:1179-1181 (22 November), doi:10.1136/bmj.327.7425.1179

Editorial

Monitoring drug treatment

Criteria used for screening tests should apply to monitoring

The first 150 words of the full text of this article appear below.

We all want our treatments to work, and none of us wishes treatment to cause harm. Monitoring drug treatment is one way of seeing that a treatment works, while protecting the patient from adverse drug effects. For many patients and many treatments clinical evaluation is sufficient. An example is measuring the blood pressure in a patient on antihypertensive treatment. When therapeutic goals cannot always be directly observed, monitoring may require blood tests in order to know whether they have been reached. An obvious example is the measurement of the international normalised ratio (INR) in patients treated with warfarin. As well as ensuring that the therapeutic goal, the prevention of thrombosis, is likely to be met,¹ measuring the INR helps to avoid the risk of haemorrhage, which rises steeply as the INR increases above 2.0.²

Monitoring treatment to anticipate or detect adverse reactions to drugs before they become inevitable or irreversible . . . [Full text of this article]

Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool L69 3GE (munirp@liv.ac.uk)

West Midlands Centre for Adverse Drug Reaction Reporting, City Hospital, Birmingham B18 7QH (R.E.Ferner@bham.ac.uk)

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This article has been cited by other articles:

• Smellie, W S A, Wilson, D, McNulty, C A M, Galloway, M J, Spickett, G A, Finnigan, D I, Bareford, D A, Greig, M A, Richards, J (2005). Best practice in primary care pathology: review 1. J. Clin. Pathol. 58: 1016-1024 [Abstract] [Full text]  
• Glasziou, P., Irwig, L., Mant, D. (2005). Monitoring in chronic disease: a rational approach. BMJ 330: 644-648 [Full text]  
• Pirmohamed, M., James, S., Meakin, S., Green, C. (2004). Adverse drug reactions as cause of admission to hospital: Authors' reply. BMJ 329: 460-460 [Full text]  

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