Adverse Effects and The Patient's Perspective

When adverse effects, particulary those associated with medical errors, are reported to the public, shock and disbelief echo throughout the nation through media outlets. Despite the explanation for the perceived adverse effect, public outcry drives the outcome of the fate of those involved. When things go awry, public pressure is on to  find the responsible party, assign the appropriate blame, reprimand the individuals and take great measures to ensure the situation never happens again. The precursor to this could have merely been the patient's believe that an adverse effect has happened without one actually having occurred. This type of media attention based on the patient's perspective may prove to be detrimental to the reputation of all parties involved.

In the case of clinical trials of phamaceuticals, one of the main objectives is to perform a series of tests to determine the efficacy of the drug in comparison to a variety of possible side effects. Participants are asked to take the medications under certain conditions and their responses are documented and presented to the public using satistical data. In this controlled environment the patient's perspective as to whether an adverse event has occurred is most important to the ultimate outcome of the testing.
The fact that a drug has a mild adverse effect may not necessarily cause the drug to be rejected, there are some acceptable side effects that, when documented, allows the user to understand the risk associated with its consumption. There is no drug advertised on television devoid of mild adverse effects. Individuals understand the risks and make their determination for use based on the perpectives of clinical trial participants.

Sometimes the perspective of the patient that an adverse effect has happened can bring about changes in medications which are currently in widespread use. The firestorm surrounding the outcry proves the patient's perspective to be the most important determinant in creating a need for adjustments to keep consumer confidence intact. In the case of the Measles, Mumps and Rubella inoculations, mothers were adamant that there was a correlation between this vaccination and the increase in autism. Despite clinical tests showing otherwise, the mercury that was used in the shots were removed in an attempt to ensure that inoculations were received at the appropriate times thereby decreasing the possibility of an outbreak of these diseases. Pressure was applied on the drug companies based on a perception that an adverse event had happened.

In conclusion, a patient's perspective as to whether an adverse event has happened can be welcomed in controlled environments but cause mayhem when it takes on a life of its own. In these scenarios, the patient's perspective as to whether an adverse effect had occurred was the most important factor in the way careers were handled, drugs were marketed and perceived harmful ingredients were removed from a required inoculations. The patient's perception was the most important driving force behind the subsequent actions causing harm or perceived good in various situations.

Nicole Thomas-Tate

"Use of this medication may cause drowsiness, headaches, foot drop, hallucinations and temporary blindness lasting 1-4 years--"see" your doctor if symptoms persist."

I suffer from seasonal allergies. Every year around December, those pesky oak trees decide to do their thing and aggravate my allergies. My discomfort lasts until February (sometimes March or April if  we receive little rain) of the following year. So, essentially, my Christmas is not very merry, my New Year is not so happy and I am not feeling the love on Valentine's Day. I am not one to go to the doctor unless I am unable to relieve my symptoms with home remedies (facial steaming, nettie pot, or good old fashioned Vicks).

As I progress in years and have adopted a busier lifestyle, the home remedies are less effective and I have less patience waiting for them to "kick in".  This leads me to my current complaint. Now that I am visiting my health care provider with more frequency, I am realizing several things: 1) I have seen an actual physician 2 times in the 10 years I have been going to the doctor and everytime I go, 2) I am given a myriad of prescription, samples of medicine and told to "try this and see how it works" then told to come back in 1 week and 3) given antibiotics?

My issue? Why do I feel like a lab rat? Why am I given different medications that have contraindications? Why do you want me to "try" a medicine and then come back?
I love my Physician Assistant, we have become friends. She "gets" me as the person I am who just wants to have these meds in case the weekend gets rough or worse-I can't breathe. She knows, for the most part I won't fill the prescription and I won't use the free samples unless I have no other choice.  I feel the quality of medicines is questionable. I don't feel the medicines work and If I am suffering so badly that I throw caution to the wind and take them--I feel worse! Then it starts a vicious cycle of additional symptoms and complaints.

It has been said that "perception is reality". My perception is that the quality of healthcare as it relates to the testing of prescription medications, the push to get them approved and the relative freedom with how they are dispensed is poorly handled. So, unless and until things change drastically in this arena, I will be coughing my way through opening my Christmas presents, sneezing to the tune of Auld Lang Syne and rubbing my itchy eyes while Cupid tries to shoot me with his arrow.