Sunday, February 4, 2007

Medication Errors

This Century is beginning with a new focus on patient safety within the medical community. One of the aspects that is receiving a lot of attention is "prescribing errors". While medications are lifesaving for millions of individuals, taking certain combinations of drugs can be a recipe for disaster. Over half of all older patients take 3 drugs a day and millions of patients take 8-10 drugs daily. Add that there may be several doctors prescribing pills for various conditions and it is no surprise there can be mistakes. Recent studies have shown that physicians need to pay close attention to potentially dangerous drug combinations when writing prescriptions and also provide patients with necessary information about the drugs. The 5 elements that you need to know whenever you receive a new prescription are:
  • medication name
  • purpose of the medication
  • how to take it and what to do if you miss a dose
  • how long it should be taken (duration)
  • possible side effects

The one that gets left off most often is duration and many people with chronic conditions may not realize that they need to take their medications indefinitely. Before I made it a habit to cover every one of these elements, I often had patients return for a visit and they had stopped their medication because "It ran out and I thought I was finished". That was my fault, not theirs.

Excellent and safe health care needs to be a partnership between a physician and a patient. The Physician has the expertise about medications and it is his/her job to educate and explain why a drug is being prescribed. It is the patient's job to know the medications they are taking. Until we get an electronic medical record that provides real time information for all prescribing doctors and hospitals, it is critical that a patient carry the names and doses of their medications on a card in their wallet. If the Orthopedic doctor prescribes a new pain pill....pull out that list and show her your medication list. Ask the question "Are there any interactions with these meds that are a problem?"

Don't be shy about asking questions. Your health safety is worth it.

1 comment:

Jonathan said...

Your piece is a very clear, concise set of instructions for minimizing the risk of medication errors and a represents a strong argument for the centralization of medical records. I would add that your advice can easily be generalized to include those whose care one is overseeing, in my case my father’s. As an example of the safety need for the centralization of records, my dad’s is care is being managed by his internist with the help of four other specialists, affiliated with three different hospitals, all of whom are prescribing medication. Ensuring that all of these doctors’ prescription orders are reflected in the others records is no small task and, in the case of an emergency hospitalization, which has occurred, a critical task. I have taken to an emergency medical bracelet for my dad, which I simply change as his medications change, as the central data repository. (Getting him to accurately take all of his medication is another story entirely). By the time I’m his age, I am hoping we have moved ahead sufficiently such that my records will be available electronically to my physicians, thus making my treatment timely, effective, and safe as possible.