Patient experiences of adverse drug reactions

[摘要] Patient experience of serious ADRs and their impact on patients’ lives have not been previously explored. This thesis aims to explore the experiences of patients diagnosed with drug-induced Stevens-Johnson syndrome (SJS) and Toxic epidermal necrolysis (TEN). In addition, the very elderly are a group particularly vulnerable to ADRs, and in particular, those due to antihypertensives. This thesis thus also explores the impact of such ADRs in the elderly, on managing their hypertension optimally. Firstly, I undertook a retrospective qualitative study of adult survivors of SJS and TEN, to explore their experiences, views and perceptions. The ADR continued to affect patients’ lives long after the event. Their interpretations regarding why the ADR occurred differed and may have influenced their trust in healthcare professionals and in medicines. Clear communication, and patient education and support after the event, may therefore be important. Secondly, I undertook an analysis of internet-based personal descriptions of SJS and TEN. Authors wished to share experiences and seek advice from others, and had common concerns regarding the ADR. These findings could be used to improve the management of such patients. Finally, I undertook a retrospective cohort study in very elderly patients to determine whether ADRs to antihypertensive drugs limit the clinician’s ability to achieve blood pressure targets. Almost half the patients studied had documented ADRs which limited further intervention. Aggressive treatment of hypertension in the very elderly may therefore be difficult to achieve in practice.

[发布机构] University:University of Birmingham;Department:School of Clinical and Experimental Medicine

[关键词] R Medicine;R Medicine (General)