PHARMACIST-MANAGED MONITORING OF ADVERSE REACTIONS TO CONTRAST-MEDIA

A pharmacist-managed program for reporting, treating, and monitoring adverse drug reactions (ADRs) to contrast media is described. The radiology pharmacist at a 1000-bed multihospital medical center worked with the radiology department to revise departmental policies and procedures for reporting ADRs to contrast media. Under the revision, an ADR report must be completed and forwarded to the pharmacy department and radiology pharmacist for review. In the radiology department itself, ADRs must be documented in the computerized radiology information system in two fields, the patient's radiology file and the radiology study report. 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 radiology file and in the radiology study report are compared with the total number of ADRs reported. The incidence of ADRs is determined and compared with that for previous quarters and with published data. The treatment of each reaction is evaluated for compliance with the guidelines, the need for follow-up, and any unusual problems. Between July 1991 and December 1992, ADR documentation in the radiology file and in the radiology study report increased substantially in several divisions of the radiology department. The rates of ADRs to contrast media remained fairly constant and paralleled published rates. Compliance with the treatment guidelines was excellent. Pharmacist involvement led to improved reporting of adverse reactions to contrast media in a radiology department and to greater awareness of measures for treating and preventing them.