Adverse drug reaction reporting in Australian hospitals

Objective: To determine the status of adverse drug reaction (ADR) reporting in Australian hospitals. Method: Postal questionnaire to all 299 directors of pharmacy in Australian hospitals. Key findings: The response rate was 49.5%. Hospitals of different size were well represented: <100 beds (23%), 100-199 beds (35%) and 200-499 beds (30%). ADR policies were reported by 67% of pharmacy departments. In most hospitals, doctors or pharmacists were responsible for ADR submissions to the Australian ADR Advisory Committee (ADRAC). Follow-up action included reports to Drug and Therapeutics Committees (57%) and drug bulletins (37%). Advice on ADRs was forwarded to the patient, the general practitioner (GP) and the community pharmacist by 96%, 89% and 11% of hospitals. Methods of informing patients were verbal (91%), card (17%) or letter (13%). Methods used to notify GPs included discharge summary (70%), letter (26%) or via the patient (15%). Data from ADRAC indicated a median 2.5 (range 0-362) reports from participating hospitals in 2000. The median ADR reporting rate was 0.02% (range 0-1.09) of patient admissions. There was no association between ADR reporting rates and the existence of an ADR policy or a centralised ADR reporting system. There was an association between hospital ADR reporting rates and provision of feedback or a reward for ADR reporting (P < 0.001). Conclusions: Procedures or policies for ADR reporting are available in most Australian hospitals but this has no direct effect on ADR reporting rates. These findings suggest a gap between policy and implementation of ADR reporting. Strategies to improve ADR reporting could include improved feedback and electronic submissions to ADRAC from a centralised service.