Core data for epidemiological studies of nonmedical drug use.
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Biomedical subjects
Publications and source records attributed to J Venulet.
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The assessment of the causal relationship between the suspected drug and the adverse event represents one of the most important goals in the evaluation of individual case reports. Because of the variability of clinical judgement, there is a growing interest in systems of assessment based on clearly defined, operational criteria. In this paper we describe our approach toward this goal, the results achieved and the practical experience gained in the evaluation of over 600 case reports processed by the drug monitoring unit of our company.
Effective systems for a meaningful integration and interpretation of data of heterogeneous origin are essential for successful monitoring of adverse drug reactions internationally or in multicenter programs. Particular difficulties are encountered in the area of suspected drug adverse reactions and in the area of drugs. Both problem areas are discussed in the paper.
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A rational prescription is defined as one which proposes the best pharmacological approach to obtain the therapeutic objective. To achieve this goal requires a careful consideration of factors related to: patient, disease, medication, and doctor. Concepts of risk/benefit and cost/benefit are of relevance for the therapeutic decision. The doctor also has to make an effort to assure the compliance of his patients. This requires a good understanding of the personality and of the socio-cultural background of the patient. Social pharmacology helps to appreciate and understand the role of these factors and to use them for improvement of therapeutic results.
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Consumption of drugs is steadily increasing. The reasons for this could be the diminished threshold level of acceptable sufferings, increased expectations about health, the psychological effects of a medical prescription, publicity, consumer society attitude in respect to drugs and polipharmacy. Overexposure to drugs increases the risk of precipitating drug adverse reactions. This could be avoided in many cases by non-administration of an unnecessary drug. The frequency and consequences of drug adverse reactions are considerable, and WHO plays an import role in collecting data and facilitating the exchange of informations in that area.
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