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Brandon Jaramillo
ENG3010
Prof. Barlaskar
24 October 2015
Analysis of Three Genres Used in Clinical Pharmacy
In my investigation of adverse drug reaction, I had interviewed four clinical pharmacists:
Dr. Heidi Pillen and Dr. Janet Hoffman from Royal Oak Beaumont, and Dr. Jennifer Priziola and
Dr. Mike Forman. All of these individuals have given me a better understanding of the
genresThe purpose of this report is to examine three main genres discussed in my interviews
with clinical pharmacists in the management of an adverse drug reaction. These are: the standard
adverse reaction report genre, an electronic form which attempts to categorize adverse drug
reactions into broader classes of drugs; the free-text genre, which allows a healthcare
professional to document adverse drug reactions in their own words; and the ‘population-study’
genre, which uses data from groups of patients to attempt to form a comprehensive
understanding of a drug and its possible adverse reactions.
I.
Standard Adverse Reaction Report
An adverse reaction is defined as an unforeseen, or non-preventable, reaction to a drug.
When an adverse reaction happens, the standard adverse reaction report is typically the first
method of management. When a standard adverse reaction report is being written, it is after the
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adverse event happens. The adverse reaction report is written by a doctor or nurse who is
actively working with the patient, attributed to the colloquialism, ‘on the floor’.
The audience of this genre includes doctors, nurses, and clinical pharmacists. When the
initial report is filed, doctors and nurses who are unaware of the patient’s adverse reaction to a
drug are notified when attempting to order that same drug or class of drug for a patient.
The subject of the adverse reaction report is the adverse drug reaction of a patient.
Usually, common adverse reactions are listed in a drop-down menu, and additional details may
or may not be given in a separate, ‘free-text’ genre of the situation. Thus, the purpose of this
genre is to notify doctors and nurses of the patients adverse reaction to a drug or class of drugs.
However, the method used in the standard adverse reaction report is practically useful. The
report describes the incident by providing specified drugs, reactions, and drug classes which .
The clinical pharmacist is not ‘on the floor’ like doctors and nurses. Therefore, the role of
the clinical pharmacist in this genre is to interpret the report and provide guidance for nurses and
doctors on how to deal with the situation. Nurses are usually given information on how to deal
with the immediate reaction, while Doctors are usually given information on alternatives to the
drug that caused the adverse event.
II.
Free-Text
The free-text genre, whilst is technically included in the adverse drug report, should be
considered its own genre for two reasons. Firstly, it allows a healthcare professional to describe
exactly what he or she saw. Occasionally, the free-text can provide information on extremely
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rare adverse reactions. Secondly, the information provided in a free-text may not be accurate of
the actual situation; that is, the value of the information given in a free-text varies, while the
Because the free-text genre is technically included with the standard adverse reaction
report, many of qualities of the genre are the same; the scene, situation, subject, and purpose can
generally be regarded as identical to the standard report.
However, the varying accuracy of the information in a free-text report adjusts the freetext’s quality. The role of the clinical pharmacist in this genre is to take into account this
information with the free-text. For example, a free text may say that a patient is ‘crazy’, which
provides very subjective information. In contrast, details such as ‘angioedema’ or ‘anaphylaxis’
refer to more specific conditions which are more rare or helpful to clinical pharmacists.
III.
Population-Study
IV.
On some occasions, clinical pharmacists contribute patient data to a comprehensive
report on a specific adverse reactions associated with specific drugs. Though technically this is
the ‘medical journal article’ genre, it sets itself apart by providing a study of a population. Thus,
we will ascribe this genre the ‘population-study’ genre.
This genre was only briefly mentioned in the interview with Dr. Priziola and Dr. Forman.
However, Dr. Priziola had mentioned that she had published papers dealing with population
study. I will use a paper from a group that she was a part of, entitled Argatroban Dosage
Requirements and Outcomes in Intensive Care versus Non–Intensive Care Patients.
Because the data is gathered from previous patients, the population-study happens after
the adverse event has happened. Specifically, the paper’s data comes from “Thirty-eight ICU
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patients and 43 non-ICU patients who received the institutional protocol of argatroban” (1). It
attempts to look at the adverse reaction and corresponding drug in a wider perspective and to be
discussed with a wider audience. This specific paper is divided into multiple parts, which dictate
the flow of the article. At the beginning, there is an overview section, which presents the
purpose, methods, and conclusions of the study. Not included in this overview there is also a
discussion section, which discusses the quality, discrepancies and implications of the study.
While made by clinical pharmacists, the audience of the population-study includes also
includes clinical pharmacists who wish to study the same drug. Otherwise, the genre intends to
be read by other health professionals, such as doctors, as the information is highly technical.