Ethnic differences in risks of adverse reactions: Biomedical approach is insufficient to explain ethnic differences

doi:10.1136/bmj.332.7554.1393-a

BMJ 2006;332:1393 (10 June), doi:10.1136/bmj.332.7554.1393-a

Letter

Ethnic differences in risks of adverse reactions

Biomedical approach is insufficient to explain ethnic differences

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

EDITOR—McDowell et al conclude that ethnic group may beone determinant of harms of a given treatment in an individualpatient.¹ Genomics is insufficient to explain ethnic differences.The authors did not tackle compliance with pharmacological agentsprescribed to patients by doctors including the subject of thedoctor-patient relationship. Most studies of adverse drug reactionsand encounters between patients and doctors were carried outin Europe and North America, with fewer doctors from ethnicminority groups.

Biopsychosocial and cultural research has shown that compliancewith treatment cannot be ignored if doctors are to appreciatethe "effects" of the agents they prescribe to patients. A quantitativestudy of antihypertensive drug treatment among Caribbean hypertensivesubjects found that when symptoms such as headaches and feelinghot were absent, dosages were skipped.² The drugs were not takenon these days because of the patient's lay and cultural beliefsabout blood pressure, . . . [Full text of this article]

Sam W P Mhlongo, professor of family medicine

University of Limpopo, Medunsa Campus, Medunsa 0204, South Africa smmhlong@iafrica.com

Acquira J Mbokazi, deputy dean of medicine

University of Limpopo, Medunsa Campus, Medunsa 0204, South Africa

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