Medicating Your Patients

Years ago patients would see the doctor and would be closely followed for one or two prescribed medications. Adverse interactions were rare. Today many people over the age of 50 are taking at least four or five medications and many could be taking up to 15 different drugs daily. Over 3.5 billion prescriptions are filled annually in the United States, from among 20,000 prescription drugs to choose from. Given the size of these numbers, it is not surprising that medication error is one of the most pressing concerns that doctors, medical institutions, and patients face in healthcare. The Institute of Medicine reports that medication errors injure or kill over 1.5 million people annually. These critical mistakes are preventable and involve both prescription drugs, and over the counter products, including vitamins, minerals, or herbal supplements. Errors occur in all steps of the medication process. The causes include the following:

• 1. Prescribing errors - This happens at the point of care when healthcare professionals send handwritten prescriptions to the pharmacy that are illegible, resulting in misinterpretation of the actual medication or the dosage when the order is transcribed. Prescribing errors also happen when there is incomplete information among a team of healthcare professionals caring for a particular patient.

• 2. Drug-handling errors when full strength medications must be diluted for different applications.

• 3. Drug dispensing errors where the wrong medication is given to the patient.

• 4. Packaging and labeling errors, when drugs with similar names, abbreviations, or packaging are confused. Look alike and sound alike drug names cause one product to be mistaken for another. The use of abbreviations for drug names can result in the wrong medication or an incorrect dose given to a patient.

• 5. Adherence when patients do not follow instructions or choose to discontinue their medication, or are so confused by the instructions on the packaging of their prescription that they really do not know how to take the drug.

• 6. Human error that just happens particularly among healthcare workers who work long hours under highly stressful conditions.