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Introduction
Current institution
Additional affiliations
September 2015 - present
September 2011 - August 2015
January 2004 - December 2011
Publications
Publications (108)
Adverse drug reactions to prescribed medication are relatively common events. However, the impact such reactions have on patients and their attitude to reporting such events have only been poorly explored. Previous studies relying on self-reporting patients indicate that altruism is an important factor. In the United Kingdom, patient reporting star...
Background:
Adverse drug reactions (ADRs) cause significant morbidity and mortality and account for around 6.5% of hospital admissions. Patient experiences of serious ADRs and their long-term impact on patients' lives, including their influence on current attitudes towards medicines, have not been previously explored.
Objective:
The aim of the s...
To examine Primary Care Trust (PCT) demographics influencing general practitioner (GP) involvement in pharmacovigilance.
PCT adverse drug reaction (ADR) reports to the Yellow Card scheme between April 2004 and March 2006 were obtained for the UK West Midlands region. Reports were analysed by all drugs, and most commonly reported drugs ('top drugs')...
Graphs have been used in attempts to show a relationship between the measles, mumps and rubella virus (MMR) vaccine and autism. We examine the topic of graphical representation of data in general, and one of these graphs in particular: the one that appeared in a 1999 letter to The Lancet. That graph combined data from England and from California, U...
Introduction: Spironolactone is increasingly being used in the treatment of heart failure. However, it has been associated with cases of hyperkalaemia. The common use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin-2 receptor (AT2) antagonists in heart failure increases the risk of hyperkalaemia.
Objective: To identify the risk of...
Background: Serious adverse drug reactions (ADRs) can lead to hospital admission and can be fatal, but some of them are preventable. This study aimed to determine the types and frequencies of serious cutaneous ADRs and the methods employed to manage and prevent them, as well as to assess the factors related to their seriousness. Methods: A cross-se...
Background
Chronic kidney disease (CKD) is associated with comorbidities and altered pharmacokinetics, making appropriate prescribing, and monitoring necessary to minimise drug-related problems (DRPs). Therefore, this study aimed to describe the drug-utilisation pattern in hospitalised CKD patients.
Methods
An observational study was conducted in...
Background
Deprescribing, a process of dose reduction or withdrawal of inappropriate medication that no longer has benefit, is a proposed intervention in the care of older adults living with frailty.
Objective/Aim
To evaluate the safety, effectiveness, and clinical impact of deprescribing services in frail patients
Methods
A systematic literature...
Background
Few studies have examined the use of self-screening tools and patient alert cards (PAC) for screening adverse drug reactions (ADRs).
Aim To examine the efficacy of self-screening tools and PAC for screening ADRs.
Methods A cross-sectional survey of outpatients was conducted at a tertiary care teaching hospital. The sample included pat...
Background: Few studies have been conducted on how patients identify, manage, and prevent severe adverse drug reactions (ADRs). This study aimed to explore the reasoning that patients use to identify symptoms of severe ADRs and the methods they employ to manage and prevent them. Methods: A cross-sectional survey using structured telephone interview...
Background:
Opioid deaths have increased in England and Wales. Coroners' Prevention of Future Deaths reports (PFDs) provide important insights that may enable safer use and avert harms, yet reports implicating opioids have not been synthesized. We aimed to identify opioid-related PFDs and explore coroners' concerns to prevent future deaths.
Metho...
Background:
Coroners, who hold inquests to determine the causes of unnatural deaths in England and Wales, having recognised factors that could cause other deaths, are legally obliged to signal concerns by sending 'Reports to Prevent Future Deaths' (PFDs) to interested persons. We aimed to establish whether Coroners' concerns about medications are...
Hospital-acquired pneumonia (HAP) is the most common healthcare-associated infection (HCAI) contributing to death. Rising antimicrobial resistance has resulted in few effective antibiotics for HAP. Stimulation of human immunity and immunomodulation have been reported as a role of vitamin D.
Objectives
1. To investigate vitamin D status of HAP pati...
Introduction:
Medicines cause over 1700 preventable deaths annually in England. Coroners' Prevention of Future Death reports (PFDs) are produced in response to preventable deaths to facilitate change. The information in PFDs may help reduce medicine-related preventable deaths.
Objectives:
We aimed to identify medicine-related deaths in coroners'...
Adverse drug reaction (ADR) severity levels are mainly rated by healthcare professionals (HCPs), but patient ratings are limited. This study aimed to compare patient-rated and pharmacist-rated ADR severity levels and determined methods employed for ADR management and prevention by patients and HCPs. A cross-sectional survey was conducted in outpati...
Background: Deaths from opioids have increased in England and Wales, despite recognition of their harms. Coroners Prevention of Future Death reports (PFDs) provide important insights that may enable safer use and avert harms, yet these reports involving opioids have not been synthesised. We, therefore, aimed to identify opioid-related PFDs and expl...
Objectives: To identify medicines-related deaths in coroners reports and to explore concerns to prevent future deaths.
Design: Retrospective case series of coroners Prevention of Future Deaths reports (PFDs).
Setting: England and Wales.
Participants: Individuals identified in 3837 PFDs dated between 1 July 2013 and 22 February 2022, collected from...
Healthcare professionals (HCPs) play a key role in the monitoring of severe adverse drug reactions (ADRs). The present study aims to explore practices and barriers of HCPs in severe ADR monitoring and reporting, to evaluate their attitudes towards the monitoring and to assess the related factors. Self-administered questionnaires produced in hard co...
Introduction
Adverse drug reactions (ADRs) can have significant negative impact on peoples' daily lives, with physical, economic, social and/or psychological effects. Patient reporting of ADRs has been facilitated by pharmacovigilance systems across Europe. However, capturing data on patients' experiences of ADRs has proved challenging. Existing pa...
Introduction
Globally, chronic kidney disease (CKD) is one of the leading causes of mortality. Impaired renal function makes CKD patients vulnerable to drug-related problems (DRPs).
Aim
The aim of this systematic review was to investigate the prevalence and nature of DRPs among hospital in-patients with CKD.
Methods
A systematic review of the lit...
Aims
The aim of this study was to determine the differences and potential mechanistic rationale for observed adverse drug reactions (ADRs) between four approved PARP inhibitors (PARPi).
Methods
The Medicines and Healthcare products Regulatory Authority (MHRA) Yellow Card drug analysis profiles and NHS secondary care medicines database enabled the...
Background Computerised Physician Order Entry (CPOE) is considered to enhance the safety of prescribing. However, it can have unintended consequences and new forms of prescribing error have been reported. Objective The aim of this study was to explore the causes and contributing factors associated with prescribing errors reported by multidisciplina...
Objective
Non‐steroidal anti‐inflammatory drugs (NSAIDs) are widely used in endurance running and by elite athletes. We examined the pattern of use of NSAIDs, the purpose of use and knowledge of the adverse effects of NSAID use in a population of recreational runners at Parkrun UK.
Methods
An online observational non‐interventional cross‐sectional...
Aim
To determine the use and perceived value of different information sources that patients may use to support identification of medicine side effects; to explore associations between coping styles and use of information sources.
Background
Side effects from medicines can have considerable negative impact on peoples’ daily lives. As a result of an...
Objectives: No studies describing UK patient Yellow Card reports have been published since the evaluation of the first two years of direct patient reporting (2005–7), when 5,180 reports were analyzed.
Methods: Patient Yellow Card reports submitted July-December 2015 for vaccines and other drugs were analyzed. Comparisons to the initial evaluation w...
Purpose
Research into causality assessment tools enabling patients to assess suspected adverse drug reactions (ADRs) is limited. Supporting patients with tools could improve their confidence in discussions with health professionals and encourage reporting of suspected ADRs to regulators. This study describes development and preliminary validation o...
Objectives
An aging UK population and multi-morbidity means patients are receiving an increasing number of medicines. This can lead to greater risk of unintended side effects. The aim of this study was to increase understanding of how people identify and manage side effects from their medicines.
Design
A qualitative interview study with patients w...
Objectives: To determine UK pharmacists’ experiences of their current communication skills and undergraduate training and to identify communication skills training and teaching at UK schools of pharmacy. Methods: Two surveys were developed. The first survey was sent to UK practicing pharmacists examining their current communication skills and inter...
Introduction
Coroners inquire into sudden, unexpected, or unnatural deaths. We have previously established 99 cases (100 deaths) in England and Wales in which medicines or part of the medication process or both were mentioned in coroners’ ‘Regulation 28 Reports to Prevent Future Deaths’ (coroners’ reports).
Objective
We wished to see what response...
Objective
To explore amateur endurance athletes’ use and views about non‐steroidal anti‐inflammatory drugs (NSAIDs).
Methods
An online cross‐sectional survey of amateur athletes at four athletic clubs.
Key findings
Of a sample of 129 of amateur athletes, 68% (n = 88) reported using NSAIDs in the previous 12 months (84.4% in triathletes, 70.9% in...
IntroductionSince legislation in 2009, coroners in England and Wales must make reports in cases where they believe it is possible to prevent future deaths. We categorised the reports and examined whether they could reveal preventable medication errors or novel adverse drug reactions. Methods
We examined 500 coroners’ reports by pre-defined criteria...
Background:
The immediate administration of oral antiplatelet therapy in the form of aspirin plus a P2Y12 inhibitor is the universally recognised standard of care for patients who present with acute myocardial infarction. Despite strong recommendations for their use, there are a paucity of data describing their onset of action and clinical efficac...
McCartney’s view that the regulation of herbal products leads to the potential for non-evidence based herbal preparations being given a cloak of scientific credibility ignores the counter-argument that such regulation is an important public health measure.1
Increasing concerns about the safety of herbal drugs, including cases of serious renal toxi...
Background: Life-threatening adverse drug reactions (ADRs) such as Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) continue to affect patient’ lives long after the event. Survivors and their relatives rely heavily on Internet sources for support and advice, but narratives of their experiences posted on patient websites have not...
Communications about the safety of medicines are complex and generally poorly performed. Discussions may not be initiated by healthcare professionals and the lack of a 'common language' to express risk can cause confusion. In the event of a serious adverse drug reaction, prior failures in communication can cause difficulties, and patients may fail...
Background:
Life-threatening adverse drug reactions (ADRs) such as Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) continue to affect patients' lives long after the event. Survivors and their relatives rely heavily on Internet sources for support and advice, but narratives of their experiences posted on patient websites have no...
Communications about the safety of medicines are complex and generally poorly performed. Discussions may not be initiated by healthcare professionals and the lack of a ‘common language’ to express risk can cause confusion. In the event of a serious adverse drug reaction, prior failures in communication can cause difficulties, and patients may fail...
The Side Effects of Drugs Annuals is a series of volumes in which the adverse effects of drugs and adverse reactions to them are surveyed. The series supplements the contents of Meyler's Side Effects of Drugs: the International Encyclopedia of Adverse Drug Reactions and Interactions. This review of the 2011 publications on antihypertensive drugs co...
Understanding the pharmacological principles and safe use of drugs is just as important in surgical practice as in any other medical specialty. With an ageing population with often multiple comorbidities and medications, as well as an expanding list of new pharmacological treatments, it is important that surgeons understand the implications of ther...
ICD-10 codings and spontaneous yellow card reports for warfarin toxicity were compared retrospectively over a one-year period
Eighteen cases of ICD-10 coded warfarin toxicity were identified from a total of 55,811 coded episodes
More than three times as many ADRs to warfarin were found by screening ICD-10 codes as were reported spontaneously using...
Safe prescribing requires accurate and practical information about drugs. Our objective was to measure the utility of current sources of prescribing guidance when used to inform practical prescribing decisions, and to compare current sources of prescribing guidance in the UK with idealized prescribing guidance.
We developed 25 clinical scenarios. T...
Our series on serious ADRs focusses on rare but important drug reactions and how to recognise and avoid them. This article describes the principal ocular adverse effects and the drugs most often implicated. Copyright © 2006 Wiley Interface Ltd
AIM(S)
To examine Primary Care Trust (PCT) demographics influencing general practitioner (GP) involvement in pharmacovigilance.
METHODS
PCT adverse drug reaction (ADR) reports to the Yellow Card scheme between April 2004 and March 2006 were obtained for the UK West Midlands region. Reports were analysed by all drugs, and most commonly reported drug...
Spontaneous reports of suspected adverse drug reactions to regulatory bodies and market authorization holders are important in pharmacovigilance. Follow-up information, which can be difficult to obtain, is often required from reporters; therefore, we developed targeted follow-up letters that we hoped would make replying easier.
To examine the effec...
Both oseltamivir and zanamivir are safe drugs with relatively few adverse effects based on clinical trial data. A theoretical risk of bronchospasm with the use of inhaled zanamivir is of concern in those with respiratory disease and there is an unknown risk of very rare skin reactions to oseltamivir. Despite the concerns about neuropsychiatric even...
Prescribing errors in diabetes have the potential to cause serious adverse effects. Antidiabetic agents are a significant cause of admission to hospital. Prescribing errors can be caused by poor handwriting, failure to communicate clearly, and by the use of inappropriate abbreviations. Serious errors involving insulin have been reported in the UK m...
Background: Spontaneous reports of suspected adverse drug reactions to regulatory bodies and market authorization holders are important in pharmacovigilance. Follow-up information, which can be difficult to obtain, is often required from reporters; therefore, we developed targeted follow-up letters that we hoped would make replying easier. Objectiv...
Struthers’s letter on reasons to be cautious about cholesterol lowering drugs may have misled readers in suggesting that the West Midlands Centre for Adverse Drug Reactions (CADRe) had issued a warning about a potential increased risk of cancer associated …
Graphs have been used in attempts to show a relationship between the measles, mumps and rubella virus (MMR) vaccine and autism. We examine the topic of graphical representation of data in general, and one of these graphs in particular: the one that appeared in a 1999 letter to The Lancet. That graph combined data from England and from California, U...
Our series on serious ADRs focusses on rare but important drug reactions and how to recognise and avoid them. This article out lines how to identify drug- induced blood disorders and describes the drugs commonly implicated. Copyright © 2007 Wiley Interface Ltd
We review important adverse drug reactions to systemic medicines that are evident in the eye. Examples include dry eye from isotretinoin; corneal deposits from amiodarone; cataract from corticosteroids; glaucoma from nebulised ipratropium bromide; and optic neuropathy from linezolid.
Public trust in childhood vaccines is crucial to achieving adequate immunisation coverage to ensure population-level immunity. However, in the UK, immunisation uptake has been adversely affected by vaccine safety scares, such as those surrounding whooping cough and measles, mumps and rubella (MMR). It is our belief that greater public awareness of...
is a serious problem in spontaneous reporting schemes, with up to 94% of adverse drug reactions (ADRs) remaining unreported.[2] This study aims to investigate the views of GPs towards the YCS, identify potential blocks on reporting and motivating factors, and develop a theoretical framework to explain GPs’ involvement in the YCS. Method: A series (...
Medical errors are increasingly being highlighted as an unnecessary cause of morbidity and mortality. Such situations are increasingly likely to occur if each country has its own improved name for each individual drug, particularly as healthcare staff are becoming increasingly mobile across the world. Standardization of drug names will help reduce...
Objectives:
To assess the extent of teaching about the Committee on Safety of Medicine's Yellow Card scheme and adverse drug reactions within UK Schools of Medicine and Pharmacy.
Methods:
A self-completed questionnaire sent to all heads of undergraduate schools of medicine and pharmacy within the UK.
Results:
The majority of undergraduate syll...
EDITOR—Morris et al discussed the use of low dose colchicine in gout.1 The treatment dose of colchicine, which has remained at 1 mg initially, followed by 500 μg every 2-3 hours for many years, should be reviewed. However, they are incorrect to …
Aim. To determine the extent of patient's knowledge of their methotrexate treatment, in terms of dose, frequency of dosing and awareness of adverse effects. Design. Structured questionnaire administered to rheumatology patients taking methotrexate. Subjects and Setting. Patients taking methotrexate at rheumatology outpatient clinics at a university...
Most cases of heart failure are because of underlying disease, but drugs can be an important factor. Corticosteroids, thiazolidinediones, and non-steroidal anti-inflammatory drugs can cause fluid overload; β-adrenoceptor antagonists, calcium antagonists and α-blockers can reduce myocardial function; and others, such as flecainide, procainamide, qui...
Objective
To analyse the content of messages to an internet mailing list for UK pharmacists and to ascertain if the list was performing a continuing professional development (CPD) function.
Method
For one month all messages to the main list were categorised by topic; details of the gender of the correspondent and their sector of the profession wer...
