The reminder by Dr Romes and colleagues that eosinophilic fasciitis
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can sometimes be drug-induced, especially the reported association with checkpoint inhibitors, is timely and important. I totally concur with their conclusion, namely that “When diagnosing . . . a thorough history and medication reconciliation is crucial.” My only comment is that this had better be viewed in a broader context.Schattner A, Glick Y. Hidden in plain sight: eosinophilic fasciitis. Am J Med2022;135(12):e432–3. https://doi.org/10.1016/j.amjmed.2022.06.011. Accessed July 31, 2022.
Iatrogenic causes were responsible for at least 19% of 2000 consecutive admissions studied, as well as 10.9%-19.5% of intensive care unit admissions.
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,3
Adverse drug events constitute a predominant cause of serious iatrogenic harm, and are often preventable. Primary care settings are no different, with a pooled prevalence of 8.32% (95% confidence interval 7.82-8.83) of adverse drug reactions among a population of 1,568,164 included in 33 studies.4
Moreover, in an era of addictive technology,- Insani WN
- Whittlesea C
- Alwafi H
- et al.
Prevalence of adverse drug reactions in the primary care setting: a systematic review and meta-analysis.
PLoS One. 2021; 16e0252161https://doi.org/10.1371/journal.pone.0252161
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when patients are often subjected to sophisticated imaging before proper history-taking and examination, clinicians may need to be reminded of the enduring irreplaceable value of the basic clinical tools, first and foremost a careful history and drug history.6
References
Schattner A, Glick Y. Hidden in plain sight: eosinophilic fasciitis. Am J Med2022;135(12):e432–3. https://doi.org/10.1016/j.amjmed.2022.06.011. Accessed July 31, 2022.
- Prevalence of iatrogenic admissions to the departments of medicine/cardiology/pulmonology in a 1,250 bed general hospital.Int J Pharmacol Ther. 2010; 48: 517-524
- Iatrogenic events contributing to ICU admission: a prospective study.Intensive Care Med. 2010; 36: 1033-1037
- Prevalence of adverse drug reactions in the primary care setting: a systematic review and meta-analysis.PLoS One. 2021; 16e0252161https://doi.org/10.1371/journal.pone.0252161
- Irresistible: The Rise of Addictive Technology and the Business of Keeping Us Hooked.Penguin Books, New York, NY2018
- Revitalizing the history and clinical examination.Am J Med. 2012; 125: e1-e3
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