Interventions unpleasantness

There is considerable confusion in the use of terminology in this area. Edwards and Aronson proposed the following definition. An adverse drug reaction is an appreciably harmful or unpleasant reaction, resulting from an intervention related to the use of a medicinal product, which predicts hazard from future administration and warrants prevention... 

Sometimes schizophrenics feel better not taking antipsychotic medications because they are able to entertain more grandiose notions about themselves and thereby lift their mood. Even more commonly, premature discontinuation occurs because patients are plagued by very unpleasant medication side effects. Like other people, they understandably don t like to suffer, and they respond by discontinuing. Appropriate education of patients regarding side effects and medical intervention (many side effects can be controlled with other medications) can improve the quality of life and greatly enhance compliance. It may be helpful to present medications as a tool for the person to use to help them control their illness, as a diabetic uses insulin. 

The nurse is administering an unpleasant-tasting liquid medication to a 2-year-old child. Which intervention should the nurse implement ... 

Nocebo Effect Unpleasant or harmful effect brought about by a placebo or a medical intervention that simulates the actual procedures. 

In contrast, a well-controlled field trial, in which the expected cost of being at fault in an accident was increased, was indeed published. The intervention resulted in a marked reduction in the accident rate of the military driver population involved (Barmack and Payne, 1961), as it did in the general driver population in Japan (see Chapter 5). Military personnel at a U.S. air force base in Texas were informed that their ranks were in jeopardy, and that they even ran the risk of dishonourable discharge from the service, if they were found to be at fault in a road accident. Referral to a psychiatrist was another unpleasant possible consequence. These measures were put into effect for 1 year and the results were compared with the accident rate before the measures were instituted, as well as with the accident rates of military personnel at other bases without the programme and with general trends. The authors concluded that the number of accidents of personnel at the experimental base diminished by 50%, the total frequency of personal injuries by 54%, and of personal injury to the driver by 60%. 

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