Outline
Introduction
A common and serious hazard of hospitalization which is associated with increased patient morbidity and mortality, prolonged hospital stays and nursing home placement with significant cost to both patients and health care organizations is called iatrogenesis. These side effects caused by medical intervention are also called adverse drug reactions (ADRs).
Iatros is a Greek word, which gives the meaning of the term ‘iatrogenesis’ as harm brought forth by a healer of any unintended adverse patient outcome because of a healthcare intervention, not considered the natural course of the illness or injury.
The revolutionary work on iatrogenesis was carried out by Ivan Illich. In his reputable work named, “Medical Nemesis,” Illich states that iatrogenesis is structural as it undermines people's competence to address their very own disease. He then additionally labeled iatrogenesis with social and cultural impacts. Social iatrogenesis has consequences from the medicalization of life, and cultural medicalization is the destruction of conventional methods of managing and experiencing loss of life, pain, and illness according to his precepts. He regarded that the iatrogenic consequences had been brought about particularly with the aid of industrialization.
Why is iatrogenesis such a serious issue?
It is the fifth leading cause of death in the world. About 5%–8% of deaths are caused due to ADRs worldwide. Around 1.4 million patients are affected by infections at any given time due to the healthcare system. 5-10% of patients are affected in developed countries while in developing countries “as many as 25% of all the patients may be affected by a healthcare-associated infection. Unsafe injection practices such as unsterilized syringes and needles worldwide account for 40% of infections. In some countries, unsafe injection practices have accounted to be as high as 70%. Unsafe blood transfusions also contribute to about 5%–15% of HIV infections. Studies have indicated that the donated blood was not at all screened for the infections such as HIV and Hepatitis in almost 60 countries worldwide.
Due to the side effects caused, it is a challenge to categorize and classify the nature of all the ADRs while thousands of drugs are currently in usage. Lack of common terminology around the world has led to various categorizations and classifications of ADRs. Medical errors/negligence, malpractices, no prior warnings about possible ADRs, over-medicalization of ill health, and commercialization of medicine are also one of the few leading causes.
How can it be prevented?
At the clinical level, iatrogenesis can be tackled by enhancing the research of drugs. Protocols have to be devised to enhance the knowledge regarding medical errors, malpractices, and negligence. The medical care provided should raise the standards and expectations for improvement. Adequate safety systems should also be built inside the healthcare system to address the problem of ADRs.
The World Health Organization (WHO) has listed essential drugs that should be implemented in all nations. Education regarding the right usage of medicine should be advocated by reputed institutions that do not take monetary favors from the companies.
The socio-cultural environment is a determinant of disease. Even the subtle imbalance in the environment shows its effects on human beings. Each country is responsible to intervene at the environmental level to lessen the nature, extent, and distribution of diseases and to enhance water quality, control vector-borne diseases, reduce air pollution, check toxic chemical exposure, and improve nutrition. Such measures should be incorporated within the plans and policies so that they have an effective influence on public health.
Sources
https://hign.org/consultgeri/resources/protocols/iatrogenesis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060929/
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