[health-vn] Unnecessary side effects, medicine abuse rampant in hospitals

[Vern Weitzel]

http://www.thanhniennews.com/healthy/?catid=8&newsid=47401

Last Updated: Thursday, March 26, 2009 23:18:32 Vietnam (GMT+07)

Unnecessary side effects, medicine abuse rampant in hospitals
	
People buy medicines from a pharmacy on Hai Ba Trung Street in Hanoi. Hospitals 
in Vietnam tend to overuse injections and prescribe too many vitamins, experts 
said at a conference in Hanoi.	More than 2,000 cases of patients suffering 
medicinal side effects were recorded in hospitals nationwide last year, and most 
of them could have been prevented, a conference in Hanoi heard Wednesday.

Experts attending the conference that aimed to promote awareness of side effects 
and abuse of medicines said Vietnam lacked a professional system to track the 
side effects of medicines and provide timely feedback to health authorities and 
patients.

They also warned that many hospitals in the country were going overboard in 
administering injections and prescribing vitamins in treating patients.

Hoang Thanh Mai of the Health Ministry’s Drug Administration office said of the 
more than 2,000 cases of side effects reported last year, 46 percent were caused 
by antibiotics, 3.5 percent by vitamins and 2.7 percent from traditional medicines.

However, she said these were statistics randomly reported by hospitals.

Health Minister Cao Minh Quang admitted information on medicines’ side effects 
collected so far has been mostly based on sponsored studies.

The tracking and information on drugs’ side effects ended when the sponsorship 
ended, he added.

Quang also said information available on results of clinical tests run on 
medicines had been insufficient in many cases.

“Many medicines had to be revoked shortly after they’d been approved because the 
side effects were more dangerous than their therapeutic value,” he said.
David Lee of the Center for Pharmaceutical Management, an international 
nonprofit organization, also said clinical tests of many medicines have been 
limited in terms of scale and duration.

The medicines, therefore, should be tracked after being sold to evaluate 
possible harmful effects and therapeutic properties, he said.

He cited several examples of unpredicted harmful reactions to several medicines, 
including Aminophenazone (or amidopyrine) - which caused the killing of white 
blood cells; Erythromycin estolate - which adversely affected the liver and 
bile; and Thalidomide – which could lead to birth defects in children.

Up to 19 percent of patients admitted to hospitals suffer harmful side effects 
from prescribed medicines but around 70 percent of these can be prevented, he added.

Abuse of injections and vitamins

The Drug Administration informed the conference that all hospitals nationwide 
had a committee tasked with supplying enough medicine as well as managing their 
quality and proper use.

However, Nguyen Thi Phuong Cham of the Health Ministry’s Diagnosis and Treatment 
Department said many committees hadn’t fulfilled their responsibilities.

“Many committees have not produced regular and timely reports on the harmful 
side effects of medicines,” she said. “Moreover, the market mechanism has had a 
bearing on some doctors in prescribing.” (Doctors are given commissions by 
pharmaceutical companies for prescribing their medicines, and tend to favor 
products that fetch them the highest commissions.)

A research study on the use of medicines at the Bach Mai hospital in Hanoi also 
found high rates in the use of injections, in as many as 82 percent of 1,800 
patient records.

Some wards in the hospital were using injections in all their treatments.
Around 50 percent of patients worldwide are prescribed injections and 90 percent 
of these cases are unnecessary, experts warned the conference.

Many hospitals in Vietnam also prescribe a large quantity of vitamins, for 
between 70 and 100 percent of its patients.

“This is an abuse of vitamins, which can have harmful effects,” said Tran Nhan 
Thang from Bach Mai Hospital. “Advertising may have contributed to the overuse 
of the vitamins.”

Le Viet Hung, principal of the Hanoi Pharmaceutical University, said several 
research studies and surveys had found doctors prescribing up to six medicines 
for one patient, exposing the patient to potential harmful effects from their 
interaction.

Reported by Nam Son