Exploring patient participation in reducing health-care-related safety risks

Patient safety, rights and medication safety in primary care in Poland
Report from the RCMADR in Kraków (1 January 2004–31 December 2010)
The analysis covers ADRs reported to the regional centre in Kraków from 1 January
2004 to 31 December 2010. The total number of reports was 2619. Detailed analysis of
these included ADRs that resulted from the following (Table 5.1):
» drug interactions in polypharmacotherapy;
» medicines–dietary supplement interactions;
» OTC drugs and prescribed medicine interactions; and
» medication errors: prescribing/administering a medication with contraindications
or existing limitations.
Table 5 .1 . Number of ADRs reported per year per category, 2004–2010
Year Drug
interactions in
polypharmacotherapy
Dietary
supplements
interactions
OTC drugs
and prescribed
medicines
interactions
Medication
errors
% of reports in
relation to all
reports sent in a
given year
2004 42 1 18 16 68.14
2005 89 2 26 25 60.68
2006 118 3 41 46 74.82
2007 186 4 48 68 79.48
2008 295 10 62 82 82.99
2009 276 12 73 91 87.25
2010 295 28 62 104 88.90
Source: authors’ own compilation based on data collected by the RCMADR.
Analysis of the ADRs confirms a continuous increase resulting from the numerous
pathologies in pharmacotherapy. This observation stems from the growing practice
of polypharmacotherapy not preceded by rational risk assessment oriented towards
potential ADRs. In addition, the Polish health care system does not provide an
objective and reliable source of patient medicine information, and treatment is usually
provided by different providers at primary and specialist care levels. These professionals
have no established practice for consulting the literature on medicines and often have
little knowledge of the characteristics of medicines prescribed by another specialist.
This makes the prevention of drug interactions and ADRs an impossible challenge in
patients who are subject to collaborative medication treatment.
Patient medication safety is also compromised by the increased use of dietary
supplements that are susceptible to interactions, with no research covering the risk of
interaction. The safety of dietary supplements is not monitored in Poland, making it
difficult to obtain an objective opinion about the safety and risks of their interactions.
The number of ADRs due to interactions between OTC drugs and prescribed medicines
is increasing. This might be related to low patient awareness of medicines interactions
or may indicate restricted access to competent sources of information on medicines
(physicians, pharmacists); it may also result from a lack of willingness to read and
understand patient information leaflets.
87