Adverse drug reactions as cause of admission to hospital: Authors' reply

doi:10.1136/bmj.329.7463.460-a

BMJ 2004;329:460 (21 August), doi:10.1136/bmj.329.7463.460-a

Letter

Adverse drug reactions as cause of admission to hospital

Authors' reply

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

EDITOR—The aim of our study was to elucidate the prevalenceof adverse drug reactions associated with prescribed medicines.We agree with Williams and Taylor that alcohol and herbal medicinesmay be contributory factors but thought that our study couldnot accurately report on this aspect because of difficultiesin verification of intake. More studies of a different designare needed in this area, and we are currently addressing therole of alcohol in warfarin related adverse drug reactions ina prospective study of 2000 patients using the AUDIT questionnaire,¹a validated instrument to assess alcohol misuse.

With regard to interactions, we accounted for all pharmaceuticalpreparations being taken by patients, and the example cited—forexample, selective serotonin reuptake inhibitors and aspirin—wouldhave been classified as an interaction. Saunders questions theuse of over the counter non-steroidal anti-inflammatory drugs(NSAIDS), which he says are freely available. Only oral aspirin. . . [Full text of this article]

Munir Pirmohamed, professor of clinical pharmacology

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

Sally James, research pharmacist

Wirral Hospitals NHS Trust, Wirral

Shaun Meakin, research nurse, Chris Green, senior pharmacist

Royal Liverpool University Hospital, Liverpool L7 8XP