Gibofsky A
Cornell University Medical College, Department of Medicine, New York, NY 10021, USA.
J Allergy Clin Immunol. 1996 Dec;98(6 Pt 3):S334-8.
Clinical risk management for the allergist focuses primarily on concerns regarding adverse occurrences and the possibility of civil litigation as a result of negligence or professional liability. Risk is substantially reduced with an understanding of such predictable drug reactions as overdosage, side effects, secondary effects, and drug interactions. In addition, all clinicians who prescribe have a duty to disclose to their patients the possibility of unpredictable reactions, including intolerance, idiosyncrasy, and allergy or hypersensitivity. This disclosure should be part of a comprehensive discussion of the risks and benefits of, and alternatives to, therapeutic agents and procedures they recommend. The process of informed consent becomes even more critical with the increasing influence of hospital and managed care formularies on prescribing decisions. Although cost effectiveness is an important factor in prescribing decisions, the possibility of adverse effects, treatment failure, noncompliance, and other negative considerations must also be weighed.
过敏症专科医生的临床风险管理主要关注与不良事件相关的问题，以及因疏忽或职业责任导致民事诉讼的可能性。通过了解诸如用药过量、副作用、继发效应和药物相互作用等可预测的药物反应，风险可大幅降低。此外，所有开处方的临床医生都有责任向患者披露不可预测反应的可能性，包括不耐受、特异反应以及过敏或超敏反应。这种披露应成为对他们推荐的治疗药物和程序的风险、益处及替代方案进行全面讨论的一部分。随着医院和管理式医疗处方集对处方决策的影响日益增大，知情同意过程变得更加关键。尽管成本效益是处方决策中的一个重要因素，但也必须权衡不良反应、治疗失败、不依从以及其他负面因素的可能性。
