asked the Minister for Health if he is aware of the concern expressed at the Irish Medical Students Association annual meeting in Galway on 22 January 1984 regarding the low level of reporting by doctors of drug side effects; and if he has proposals to meet this problem.
Ceisteanna—Questions. Oral Answers. - Drug Side Effects.
6.
I am aware of the concern expressed at the recent annual meeting of the Irish Medical Students' Association concerning the apparent low level of reporting by doctors of drug side effects.
Since their establishment in 1966 the National Drugs Advisory Board have had responsibility for obtaining and assessing reports on the adverse effects of drugs in use in this country. The board operate the system by communicating with doctors and pharmacists on a regular basis and impressing on them the need to report all side effects to the board. The rate of reporting is significantly higher in this country than is the case in many other countries. The rate increased from 3 per cent of expected reactions in 1969 to 20 per cent in 1982 and the rate for 1983 is expected to be about 22 per cent. These figures compare very favourably with those of other countries, where the average rate tends to be between 8-15 per cent.
I accept that the rate of reporting of adverse reactions should be much higher and I can assure the Deputy that the National Drugs Advisory Board will continue to urge all doctors and pharmacists to report all side effects, whether expected or not, and those of which there is only a suspicion as to the cause.
Would it be possible to list specific drugs where the danger of side effects is greater and to make it mandatory for doctors using or prescribing them to report any side effects?
In many instances doctors get an unfair amount of stick. Since 1980, medical practitioners and pharmacists are the principal sources of reports of adverse reactions. Medical practitioners account for almost 60 per cent of the total. I am a bit worried about the situation in hospitals as they report only about 25 per cent of adverse effects despite the fact that the majority of such effects occur in hospitals. As shown from the intensive monitoring of the National Drugs Advisory Board, about 10 per cent of patients in hospital experience some sort of adverse reaction to their medication while only 1 per cent of patients outside hospitals have side effects from drugs. Psychiatric, maternity and children's hospitals have a particularly poor reporting record.
In the case of hospitals, it is obviously much easier to make it compulsory to record side effects. In view of the low returns now operating, will the Minister issue a directive to the hospitals to step up the rate of reporting?
The overall rate in Ireland is quite high by European standards and, indeed, by international standards. In the United States, for example, doctors are actually paid to report adversary actions, yet their rate is about 15 per cent. I shall bear what the Deputy says in mind and try to encourage further reporting. The psychiatric, maternity and children's hospitals have a poor reporting record and we should address ourselves to this.
Have the National Drugs Advisory Board given any reason as to why the reporting in hospitals is so low? Perhaps the Minister might bring that matter up with them. It appears that they have a very low national profile.
That would be the type of issue which I would hope to refer to the National Health Council which is set up to get bodies as large as that interested in that sort of issue. I shall ask the board for a separate report and write to the Deputies on the matter.