Drug Therapy Risks

An important tenet of the Hippocratic oath that health professionals endorse is "never do harm to anyone." In recent months, we have seen a number of studies pointing out that certain drug therapies can produce harmful results. Gandhi et al?s recent article (New England Journal of Medicine, April 17, 2003) reported that side effects from prescription medicines plague 1 in 4 patients. Dr. Gandhi said, "It?s a problem that is common, in many cases the impact could be prevented or reduced, and it has a large impact on patients." Another study, by Shumaker et al (Journal of the American Medical Association, May 28, 2003), showed that estrogen plus progestin doubled the risk of dementia in women over age 65. The media were very interested in this study?s results, with stories appearing in newspapers and on radio and television, and I am sure that patients will bring many questions to community pharmacists. Could these types of studies be a reminder that, because drug therapy has negative as well as positive consequences, we should use drugs with more caution than we do now?

Whether or not we overuse drug therapy, however, is not the issue I want to debate here. I want to focus on opportunities these studies offer pharmacy. The pharmacist continues to be the most accessible health expert, because community pharmacies are everywhere. Many patients have taken this important health resource for granted. These studies remind us of the importance of the community pharmacist as a source of comfort and advice to worried patients who hear a negative report about the medication they are taking. The study results also remind us that pharmacists have an important role in helping patients make the best use of their medicines. I hope that these studies will awaken many to the important role of the pharmacist as a convenient and reliable source of information and advice. Pharmacists who know their patients can help prevent or reduce the adverse consequences of drug therapy. Let?s celebrate the opportunities we have as pharmacists to really help patients. After all, that?s why we became pharmacists.

EDITOR-IN-CHIEF

Fred M. Eckel, RPh, MS

Professor and Director

Office of Practice Development and Education

School of Pharmacy

University of North Carolina at Chapel Hill