Dec. 7, 2021

UCalgary researcher looks to improve medication safety, avoid 'sick day' drug interactions

David Campbell seeks patient input to create mobile app
David Campbell
David Campbell

According to Adverse Drug Reaction Canada, there are about 200,000 severe drug reactions in Canada annually. Sick day drug events account for more than one in 10 of those. These may occur when patients become acutely ill with communicable diseases like stomach bugs, seasonal flu and COVID-19, and they continue taking certain prescription medications which are supposed to be temporarily stopped. 

Certain classes of drugs, such as those taken by insulin-dependent diabetic people, can cause severe side effects like acute kidney injury and dangerous low blood sugar levels. 

That’s because if people don’t consume food or water due to an acute illness, their medication can accumulate in the body. These classes of drugs are used in almost all patients with heart disease, diabetes and kidney disease, so there is a risk of "sick day drug events". 

For this reason, health-care providers often warn patients not to take their medications when they are sick. However, that advice can be forgotten. 

A team of researchers at the Cumming School of Medicine, including Dr. David Campbell, MD, PhD, hope to change that with a mobile app that will serve as reminder for patients about which medications they should refrain from taking when sick. 

App idea infographic

“When someone is telling you something hypothetical that may happen at some point in the future there may be a tendency to forget,” says Campbell. “This app will be something that patients can download on their phone that will act as an external reminder.”

To kick off development of this app, Campbell and his team created focus groups that will help co-design the app. These groups include patient advisers, physicians and pharmacists The research team is conducting a patient survey to assess needs and better understand patient experiences with sick day medication management. 

The online survey is open to Canadians ages 18 and older with diabetes, hypertension, heart failure, coronary heart disease, and/or chronic kidney disease. 

Campbell says the idea is to optimize the final app by implementing input from patients. “We encourage people to contribute their experiences to the development of this new app, so it can be designed to meet not only their needs, but the needs of their loved ones,” he says. 

Online survey asks for your experiences

Patient adviser, Calgary’s Sandra Shaw, 61, lives with complex health issues including diabetes and hypertension. 

She got involved with this research project, called PAUSE, in part because her neighbour experienced an adverse drug reaction while ill that sent him to the hospital for five days. Not only did her neighbour not realize he shouldn’t take his medication while acutely ill, but his wife was also unaware. It was an eye-opener for Shaw. 

“There is a huge need for this information to be widespread,” says Shaw, who has been a patient adviser with Alberta Health Services for about 15 years.

As a patient, I was unaware that sick day drug interactions were even a possibility.

Nancy Verdin, 61, is another patient adviser on the project. A retired occupational therapist, she is aware of the burden on patients who are forced to manage complex health issues. She is excited to be part of the advisory team and optimistic about the app’s potential. 

“I think it could be a functional tool that will reduce hospital visits, build patient confidence and increase connections between individuals and their health-care providers,” says Verdin. “This study is about self-management.” 

Future options for involvement with this study will be posted here for the coming year. In the meantime, please contact research co-ordinator Nicole Lamont at

David Campbell is an assistant professor in the departments of Medicine, Cardiac Sciences and Community Health Sciences at the Cumming School of Medicine (CSM). He is also a member of the CSM’s Libin Cardiovascular Institute and O’Brien Institute for Public Health.