Addressing an Angry Patient with Adverse Drug Reaction

Summary

This scenario involves managing an angry patient who experienced an adverse drug reaction due to prescribed medication. The candidate is expected to navigate the patient's concerns, provide explanations, and offer solutions while demonstrating empathy and professionalism.

Key Points

Angry Patient Communication

• Validate the patient's feelings and acknowledge their distress.

• Clearly explain your role and purpose in addressing their concerns.

• Avoid defending or blaming colleagues; focus on constructive solutions.

• Reiterate that their feedback will help improve hospital practices.

Adverse Drug Reaction

• Acknowledge the adverse drug reaction as a serious issue.

• Explain the reasoning for prescribing the medication despite known risks (e.g., limited options due to allergies).

• Emphasize the importance of documenting such reactions to prevent recurrence.

Professional Apology

• Offer a sincere apology without admitting liability.

• Highlight steps being taken to investigate and rectify the issue.

• Assure the patient that protocols will be reviewed to minimize future risks.

Important Considerations

• Empathy: Acknowledge the impact of the incident on the patient's life, including potential financial or emotional stress.

• Transparency: Be open about the investigative and feedback processes.

• Cultural Sensitivity: Adapt explanations to suit the patient’s background and level of understanding.

Diagnostic Approach

1. Confirm Details:

   • Verify patient identity and clarify their primary concern.

2. History Taking:

   • Document the sequence of events leading to the reaction.

   • Investigate medical history, medication history, and any allergies.

3. Physical Examination:

   • Assess for ongoing symptoms or complications.

4. Document Findings:

   • Record the adverse reaction and related details in the patient’s notes.

Management

1. Immediate Actions:

   • Ensure the patient is no longer on the offending medication.

   • Provide an alternative treatment plan tailored to their condition and allergies.

2. Future Prevention:

   • Document the reaction and allergy prominently in their medical records.

   • Communicate with relevant departments to implement safeguards.

3. Referral and Follow-up:

   • Refer to a patient liaison service for formal complaints.

   • Ensure follow-up consultations for monitoring and further care.

4. Feedback Loop:

   • Use the complaint to review and potentially improve hospital protocols.

Communication Skills

• Empathy Statements:

  • "I understand how frustrating this must be for you."

  • "I’m truly sorry for the inconvenience and stress this has caused."

• Explanations:

  • Avoid medical jargon; use clear, patient-friendly language.

  • Provide context for decisions, such as limited treatment options.

• Engagement:

  • Ask open-ended questions to understand the patient's perspective.

  • Confirm their understanding of the information shared.

Ethical Considerations

• Maintain neutrality about colleagues' roles in the event.

• Ensure that the patient feels heard and their feedback is valued.

• Follow the duty of candor by being honest about what went wrong and how it is being addressed.

Additional Resources

• GMC’s Good Medical Practice guidelines on handling complaints and being open when things go wrong​​.

• PLAB exam tips on maintaining professional conduct and empathy​​.

• Hospital’s adverse event protocols for managing and reporting drug reactions.