Improving how adverse drug reactions are identified and managed in hospitals

Harmful or unintended responses to medicine – “adverse drug reactions” (ADRs) – cause serious problems for patients and place pressure on healthcare services. In England, ADRs cost the NHS an estimated £2.21bn each year. Up to 40 per cent of these are potentially avoidable. Despite this, there is limited understanding of how ADRs are managed in hospitals, and how staff and patients experience the process.

In this study, Professor Bryony Dean Franklin and Dr Aseel Mahmoud interviewed hospital staff and patients about how ADRs are identified, recorded and discussed in practice.

They found important variations in practice, as well as differences in how terms such as “allergy”, “intolerance” and “ADR” are understood and recorded. From the interviews, they also found that staff and patients have different expectations about who is responsible for checking and communicating this information. Electronic health records support documentation in some cases but can also introduce new challenges.

These inconsistencies increase the risk that important information is misunderstood or missed. This can lead to patients being given medicines that have previously caused harm. Findings from the interviews also highlight the need for clearer definitions, improved communication with patients, and more consistent documentation practices.

These findings provide a foundation for improving how ADRs are managed in hospital settings. Further research by our team will explore developing practical improvements in how hospitals collect and use ADR and allergy information.