Citation

Wiholm BE, Westerholm B. Acta Med. Scand. Suppl. 1984; 683: 107-117.

Copyright

(Copyright © 1984, Almqvist and Wiksell)

DOI

unavailable

PMID

6430038

Abstract

For a continuous monitoring and evaluation of drug safety problems in Sweden, the Department of Drugs of the National Board of Health and Welfare has access to a number of computerized patient, drug, and disease-oriented registers. The usefulness and limitations of these registers are presented by examples. A recent increase in asthma deaths is presently being analyzed by comparing information from death certificates and case records with drug sales and prescription data. A recent analysis of the cancer register showed no increased risk of malignant thyroid tumors after diagnostic or therapeutic doses of I131. Similarly no increased risk of malformations after occupational exposure to hexachlorophene could be detected by analyzing the malformation and medical birth record registers in relation to hospital hexachlorophene use. The register of patient discharge diagnoses has been repeatedly used to analyze the incidence and pattern of drug-induced blood dyscrasias and thromboembolism associated with oral contraceptives (OC). These analyses have resulted in the withdrawal of dipyrone and tenalidine and a decrease of the estrogen content of OCs. At the same time, about 1/3 of these serious adverse drug reactions (ADRs) had been reported to the ADR register. By combining sales and prescription data with ADR reports, the risk of inducing lactic acidosis was significantly higher for phenformin than for metformin. Also, the incidence of tardive cyskinesia from longterm use of metoclopramide was much higher than recognized previously. With these registers it is opossible to obtain valuable information about drug safety. The raw data must, however, be interpreted with care and often be supplemented with in-depth studies of the various problems.

Language: en