PHARMACIST-MANAGED MONITORING OF ADVERSE REACTIONS TO CONTRAST-MEDIA

A pharmacist-managed program for reporting, treating, and monitoring a dverse drug reactions (ADRs) to contrast media is described. The radio logy pharmacist at a 1000-bed multihospital medical center worked with the radiology department to revise departmental policies and procedur es for reporting ADRs to contrast media. Under the revision, an ADR re port must be completed and forwarded to the pharmacy department and ra diology pharmacist for review. In the radiology department itself, ADR s must be documented in the computerized radiology information system in two fields, the patient's radiology file and the radiology study re port. The radiology pharmacist developed guidelines for preventing and treating ADRs to contrast media. Boxes containing drugs specifically indicated for the treatment of these ADRs were distributed throughout the radiology department. The radiology pharmacist prepares a quality improvement report each quarter. ADRs documented in the patient's radi ology file and in the radiology study report are compared with the tot al number of ADRs reported. The incidence of ADRs is determined and co mpared with that for previous quarters and with published data. The tr eatment of each reaction is evaluated for compliance with the guidelin es, the need for follow-up, and any unusual problems. Between July 199 8 and December 1992, ADR documentation in the radiology file and in th e radiology study report increased substantially in several divisions of the radiology department. The rates of ADRs to contrast media remai ned fairly constant and paralleled published rates. Compliance with th e treatment guidelines was excellent. Pharmacist involvement led to im proved reporting of adverse reactions to contrast media in a radiology department and to greater awareness of measures for treating and prev enting them.