Why Don’t We Adequately Identify and Manage Adverse Drug Reactions despite Having the Needed Information?

Importance/Objective: Adverse Drug Reactions (ADRs) are unavoidable, but recognizing and addressing ADRs early can improve wellness and prevent permanent injury. We suggest that available medical information and digital/electronic methods could be used to manage this major healthcare problem for individual patients in real time. Methods: We searched the available digital applications and three literature databases using the medical subject heading terms, adverse drug reaction reporting systems or management, filtered by clinical trial or systemic reviews, to detect publications with data about ADR identification and management approaches. We reviewed the reports that had abstract or summary data or proposed or implemented methods or systems with potential to identify or manage ADRs in clinical settings. Results: The vast majority of the 481 reports used retrospectively collected data for groups of patients or were limited to surveying one population group or class of medication. The reports showed potential and definite associations of ADRs for specific drugs and problems, mostly, but not exclusively, for patients in hospitals and nursing homes. No reports described complete methods to collect comprehensive data on ADRs for individual patients in a healthcare system. The digital applications have ADR information, but all are too cumbersome or incomplete for use in active clinical settings. Several studies suggested that providing information about potential ADRs to clinicians can reduce these problems. Conclusion and Relevance: Although investigators and government agencies agree with the need, there is no comprehensive ADR management program in current use. Informing the patient’s healthcare practitioners of potential ADRs at the point of service has the potential for reduction of these complications, which should improve healthcare and reduce unneeded costs.

Effective Medical Creation (EMC) <br/>—A New Approach to Improvement of Patient Management in the Standpoint of Hospital Room Environment

Effective Medical Creation (EMC) is a kind of campaign to implement a team healthcare that can provide the most efficient and effective intensive care units (ICUs) by improving hospital room environment for not only patients and their family but also healthcare providers. This campaign was based on the concept of the “Art of Medicine”, which provides everyone a comfortable ICU environment of meditation and feeling with the five senses of sight, hearing, touch, smell, and taste. EMC can provide a healthcare environment that is not restricted by existing and traditional verse rules or style and aims to always provide better healthcare by working on the five senses. Provision of facilities for aromatherapy massage at an ornamental hospital room and landscape through a false window has been the ongoing activity of the EMC at Nara Medical University. These seemed effective in reducing a patient’s stress response in the ICU. However, the effect of EMC on the outcomes of critically ill patients has not been determined. EMC might be one of the promising measures to create environments that positively affect both patients and healthcare providers. In this review article, the concept of EMC and practice of EMC at Nara Medical University Hospital are presented.