Medical record linkage offers potential benefits for postmarketing surveillance. The Saskatchewan Health datafiles record administrative information, which is linkable using unique numbers issued to each resident. The value of these datafiles in an acute adverse drug reaction (ADR) alerting scheme has been assessed using 2 nonsteroidal anti-inflammatory drugs (NSAIDs). The first 20 000 patients who were dispensed piroxicam and the first 20 000 who were dispensed sulindac were followed over the year after their initial prescription of the relevant drug and all medical events occurring during treatment were recorded.
The most frequent ADRs to NSAIDs are gastrointestinal problems. Although the rate of abdominal pain/swelling in the first month after the initial prescription was significantly greater than that in the succeeding 6 months among both drug groups, there was no strong indication of serious acute gastrointestinal ADRs in either group. Nevertheless, the results indicate that the use of administrative datafiles in a systematic evaluation of acute ADRs is a feasible and practical prospect.