Medication Errors Cause Patient Injury
Given the serious potential for medication errors and drug-induced disease, especially among older adults, it’s important to take precautions to minimize the probability of your medications compounding, rather than helping, your medical conditions and driving up your medical risks and costs. Here are a few suggestions for doing so.
Know your pharmacist by name – Pharmacists generally know more about drugs’ properties and potential for adverse interactions than physicians and most now have computer programs to help them flag medication errors and other possible problems.
They need to know all the drugs you’re taking, however, so it’s ideal to have all your prescriptions filled by one pharmacy. It’s also wise to inform your pharmacist of any vitamins, herbs, or supplements you’re taking that may also interact with your medication(s).
Given time-constraints on medical practice that aren’t likely to improve anytime soon, having a pharmacist who knows you and your medication regimen can help protect you from medication errors;
2. Ask questions – Ask your doctor(s) and pharmacist about side effects and any adverse events associated with the drug’s use, especially in patients your age. Since so few doctors volunteer this information, patients need to take the initiative by asking explicitly why you’re being prescribed a drug, at exactly what dose, and when to take it (with meals or not, at bedtime). Also ask whether you should have any lab tests to monitor the drug’s effects and when;
3. Bring your medications – “Brown Bagging” all your meds to your doctor’s visit assures he or she knows exactly what you’re taking and may prompt adjustments or elimination of one or more you may no longer need. It’s also advisable to print out a list of them to keep in your purse or wallet for emergencies;
4. Check prescriptions for legibility – If your doctor is still using hand-written prescriptions, make sure you can read his or her writing before leaving the office. Ask the office staff for any clarifications, including abbreviations (example: “q.d” means every day, while “q.o.d. means every other day; mistaking the “o” for a period could leave you with a double dose). If you can’t read it, the pharmacist may not be able to either (this is a major source of medication errors);
5. Double-check on pick-up – Don’t be in a rush to leave the pharmacy before checking each prescription, including opening the bottle and making sure you recognize the pill (unless it’s a new prescription). If it doesn’t look right, ask about it; and
6. Avoid the first of the month – Just as hospitals are more dangerous on evenings and weekends, fatalities due to pharmacy errors – an estimated 30 million dispensing errors occur annually – increase by up to 25% during the first few days of the month when Social Security recipients cash their monthly checks and swamp pharmacies, increasing medication error rates.
In addition, the Institute for Safe Medication Practices offers a personalized “MedSafetyAlert” in which you enter all your medications and supplements and receive email alerts if and when new information about interactions or safety arises. It also checks for drug interactions and safety ratings.
Medscape also offers a “Drug Interaction Checker” for those wishing a more “hands-on” approach at medscape.com/druginfo/druginterchecker?src=ads. Finally, Medical Opinion offers a fee-based medication “second opinion” service at m-opinion.com/Drug+Safety/.
In addition, select supplements have been shown to interact synergistically with certain medications to improve their effectiveness. Combining fish oil with cholesterol-lowering statin drugs (Lipitor, Crestor, etc) is a prime example.
This can permit, for some patients, a reduced drug dosage without reducing the effectiveness of the medication.
There are other alternatives to adding more drugs to your treatment regimen – which increases your risk for both medication errors and negative drug interactions – such as outreach programs where nurses and pharmacists follow-up type 2 diabetics between office visits and adjust their medications.
This outreach and follow-up intervention reduced blood sugar levels better than most medications. The alternative is adding another diabetes medication as initial drugs lose their effectiveness over time – the standard practice in medicine today.
And a study reported earlier this month suggests that patient self-monitoring of blood pressure resulted in blood pressure reductions that either delayed the need for medications or enabled lower doses than would otherwise prove clinically effective.
These examples raise the obvious question: Why are patients required to absorb added risks of toxicity and medication errors – as well as the added expense of another medication – when better management of their current medications often works better without increasing these risks?
Expediency Trumps Patient Safety
The answer is simple. It’s more expedient for your doctor to prescribe another medication, which enables him or her to see more patients to enhance his or her income. And pressure on doctors’ office time is likely to increase as more patients enter the system as Obamacare is fully implemented.
Which means patients will need to be more vigilant and assertive in exploring alternatives to the ever-handy prescription pad if they wish to reduce their risk for medication errors.
Because medications aren’t risk-free – and can often cause more harm than good.
Which is why it’s prudent to follow the above suggestions to minimize these risks to you and your family.
 Don’t be a victim of pharmacy errors. CNN.com/health. 10/30/07.