International Journal of Risk & Safety in Medicine - Volume 2, issue 1
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The International Journal of Risk and Safety in Medicine is concerned with rendering the practice of medicine as safe as it can be; that involves promoting the highest possible quality of care, but also examining how those risks which are inevitable can be contained and managed.
This is not exclusively a drugs journal. Recently it was decided to include in the subtitle of the journal three items to better indicate the scope of the journal, i.e. patient safety, pharmacovigilance and liability and the Editorial Board was adjusted accordingly. For each of these sections an Associate Editor was invited. We especially want to emphasize patient safety. Our journal wants to publish high quality interdisciplinary papers related to patient safety, not the ones for domain specialists. For quite some time we have also been devoting some pages in every issue to what we simply call WHO news. This affinity with WHO underlines both the International character of the journal and the subject matter we want to cover. Basic research, reports of clinical experience and overviews will all be considered for publication, but since major reviews of the literature are often written at the invitation of the Editorial Board it is generally advisable to consult with the Editor in advance. Submission of news items will be appreciated, as will be the contribution of letters on topics which have been dealt with in the journal.
Abstract: Cardiac glycosides are among the drugs most commonly used in elderly patients and constitute approximately 3% of all prescriptions filled by these patients. Recipients of digitalis usually show high levels of concomitant drug use. In this study 1,128 users of cardiac glycosides users were matched 1:1 by age, gender and community to non-users. Concomitant drug use patterns in the users group were compared with such patterns in the non-users group. Utilization data were drawn from a sample of pharmacy records (population size: n=74,445). Digoxin accounted for 99% of all digitalis prescriptions. Digoxin use seems to be an important predictor for…high morbidity levels and consequent drug use. The prevalence of use of anticoagulants, thyroid drugs, anti-diarrheals, anti-diabetics, anti-hypertensives and diuretics was 2–4 times higher in the digitalis group. Concomitant drug use patterns in naturally occurring groups of patients may provide an important source of information on the health status of recipients of digoxin.
Keywords: Cardiac glycosides, Cardiovascular diseases, Concomitant drug use, Drug utilization, Pharmacoepidemiology, Matched-pairs
Abstract: The exact mechanisms of adverse reactions to contrast media are still imperfectly known; they may, however, be idiosyncratic or non-idiosyncratic. Non-idiosyncratic reactions can be prevented by using new non-ionic contrast agents. Idiosyncratic reactions can be prevented by specific premedication. Patients with a history of idiosyncratic reactions may benefit from prophylactic administration of corticosteroids and antihistamines. Patients who seem more likely than others to react to contrast media must be premedicated, the risk of a reaction being detected and evaluated by questioning. It has recently been suggested that all patients about to receive an intravascular injection of contrast medium should also…be premedicated.
Abstract: Editorial Note: The weekly medical journal of The Netherlands – the Nederlands Tijdschrift Door Geneeskunde – has for many years periodically sponsored expert meetings to consider medical topics of current importance. On June 15th 1990, the Journal held a conference on the situation created by the promised common market for pharmaceutical products which is to be created by the European Community. The views expressed there represented professional reactions in one member state to a development which has been motivated by international economic interests rather than considerations of health or medical care. The report which follows appears simultaneously in Dutch…in The Netherlands (Ned Tijdschr Geneesk 1990; 134, Nr. 38).
Abstract: Editorial Note: In the three decades which have passed since the need for more thorough studies of the side effects of pharmaceuticals was thrown into sharp profile by the thalidomide disaster, much has changed in the way in which these unwanted effects of drugs are approached and the extent to which they are understood. The three papers which follow in this issue open a series which seeks to provide a concise update of each of the principal methods which underlie the science and art of adverse reaction study. The papers were presented at a closed meeting jointly organized by…the European Regional Office of the World Health Organization and the W.H.O. Collaborating Centre for Public Health Research, Kiel, Germany, on 26–29 November 1990, under the Chairmanship of Prof. Fritz Beske. The series will continue in future issues of the Journal.