Ask questions, read info to avoid medicine errors
By Mary Anna Sullivan, M.D.
Both in the hospital and at home, medication errors are among the highest number of errors we experience in medicine. The Centers for Disease Control estimates that adverse drug events cause more than 700,000 emergency room (ER) visits and 120,000 hospitalizations each year. Such errors are costly and too common; some end in tragedy. Many, however, are preventable.
The reasons why medication errors happen are many and varied.
Patients are taking more medications than ever. Current estimates are that 82 percent of Americans take a least one prescription medication, and 29 percent take five or more. That’s likely to continue: the nation’s population is aging, chronic diseases such as diabetes and arthritis are rising, new medicines are constantly being developed, and huge amounts of advertising for both prescription and over-the-counter drugs reach consumers directly, creating interest and demand for a wide variety of remedies.
Other factors contributing to errors include patient confusion or misunderstanding in taking medicines; drugs with similar sounding names; and drug interactions with other medicines, alcohol, or certain foods.
The amount of drugs, medicines, and supplements available to patients today is enormous. Pharmacies are filled with scores of over-the-counter medicines, in different dosages and formulations. The number of commonly prescribed prescription medicines is vast (more than 1,100 according to Physicians’ Desk Reference, a commercially published volume of information on drugs); and herbal medicines and vitamins many touted as alternative or preventive remedies - are readily accessible.
Technological advances such as electronic prescribing help to reduce errors, but e-prescribing is not yet universally used, and it doesn’t capture products we buy over-the-counter, many of which can be quite potent.
The important thing to remember one that bears repeating is that many medication errors are preventable. Here are steps to take for the safe use of medications.
- Ask questions When prescribed a medicine, ask lots of questions. Why is this being prescribed? How long must I take it? Are there side effects? Will it interfere with other medications I’m taking? Do I really need this or would another treatment work?
- Read the information Each prescription comes with information, containing a description of the medicine, including how and when (e.g., with or without food; how many times a day) to take it, cautionary advice, and possible side effects. Read it carefully. Do the same for over-the-counter medicines.
- Keep a list Record each medicine you take regularly, including frequency, amounts, and why you’re taking it. Keep this “med list” up to date and with you at all times. It’s a tool that could prevent harm and save your life.
- List them all Include over-the-counter medicines, herbals or vitamins, on your med list and in discussions with your physicians and pharmacist. Some of these can interact with prescription medications or certain foods.
- Share information Bring your list to every doctor’s visit. All your physicians (and pharmacist) should know everything you’re taking. This will help to avoid adverse interactions if you’re prescribed a new medication.
- Befriend a pharmacist Pharmacists are a critical part of medication safety and an important source of information about prescriptions and over-the-counter medicines.
- Supervise young and old Be extra attentive with children and the elderly. Adults 65 and older are twice as likely to visit an emergency department for an adverse drug event, and some 53,000 children under 5 wind up in the ER due to unsupervised ingestions of medicines.
- Check the bag Whenever you get a prescription filled, check before you leave the pharmacy to make sure it’s what the physician prescribed.
- Follow instructions If you don’t take the medicine when and how you should, not only could problems occur, but you also won’t get the full benefits from it.
Medication safety is a team sport, with the physician, pharmacist, and patient all playing key roles. The patient, however, as the last link in the chain and the ultimate consumer, must be extra vigilant.
For more information, visit www.ConsumerMedSafety.org
. For free copies of a consumer guide to safe medication use and a pocket-size patient med list, visit the Massachusetts Coalition for the Prevention of Medical Errors at www.macoalition.org
. And for a video discussion on the topic, visit www.physicianfocus.org
Mary Anna Sullivan, M.D. is president of the Massachusetts Coalition for the Prevention of Medical Errors and Chair of the Department of Psychiatry and Chief Quality and Safety Officer at Lahey Clinic in Burlington, Mass. Physician Focus is a public service of the Massachusetts Medical Society. Readers should use their own judgment when seeking medical care and consult with their physician for treatment. Send comments to PhysicianFocus@mms.org