Hot Topic

Prescription Drug Errors and How to Avoid Them

August 2006

The National Institute of Medicine released a report in July 2006, and it is sobering: medication mistakes injure more than 1.5 million Americans a year; and more than 7,000 may die because of it. There are an estimated 400,000 preventable drug errors in U.S. hospitals each year.

Yes, it's terrifying as just when you are sickest and need today's powerful medicines, someone might give you the wrong one or too much or not enough.

So what's a lay person to do? I would propose you ask a lot of questions as drugs are prescribed or administered for you or a loved one; don't be bashful, don't feel it shows lack of respect for the provider. No one intends to make a medication error, but they happen all the time. Could your question to a nurse, doctor or pharmacist help them prevent a potential serious mistake?

The Institute of Medicine has created a very handy list of what you can do to avoid medication errors. Some of the tips include:

At Home

• Maintain a list of prescription drugs, nonprescription drugs and other products, such as vitamins and minerals, you are taking.
• Take this list with you whenever you visit a health care provider and have him or her review it.
• Be aware of where to find educational materials related to your medications in the local community and at reliable web sites.

At the Pharmacy

• Make sure the name of the drug (brand or generic) and the directions for use received at the pharmacy are the same as that written down by the prescriber.
• Know that you can review your list of medications with the pharmacist for additional safety.
• Know that you have the right to counseling by the pharmacist if you have any questions. You can ask the pharmacist to explain how to properly take the drug, the side effects of the drug, and what to do if you experience side effects (just as you did with your prescriber).
• Ask for written information about the medication.

At the Clinic

• Have the prescriber write down the name of the drug (brand and generic, if available), what it is for, its dosage, and how often to take it, or provide other written material with this information.
• Have the prescriber explain how to use the drug properly.
• Ask about the drug's side effects and what to do if you experience a side effect.
• Make sure the prescriber has been given the complete list of all medications you are taking so that they don't prescribe something that would react adversely to another one of your medications.

At the Hospital

• Ask the doctor or nurse what drugs you are being given at the hospital.
• Do not take a drug without being told the purpose for doing so.
• Exercise your right to have a surrogate present whenever you are receiving medication and are unable to monitor the medication-use process yourself.
• Prior to surgery, ask whether there are medications, especially prescription antibiotics, that you should take or any that you should stop taking preoperatively.
• Prior to discharge, ask for a list of the medications that you should be taking at home, have a provider review them with you, and be sure you understand how these medications should be taken.

Get Organized

Another common cause of either medication error or lack of effectiveness of your medications is confusion leading to not taking the drugs as they were prescribed. As we age, the likelihood is high that we'll be taking a variety of pills. It's hard to keep track of what they are, when to take them and all the directions that go along with them: take with food (or not), take in the morning, evening or every three hours, take three times a week or daily. It can be overwhelming. However, there are a couple of easy ways to make it simpler.

First, organize your medications in one of those handy pill boxes with slots marked for each day. Then draw up a spreadsheet with a list of all your medications and when and how to take them. If you're not computer savvy, have a friend or one of your children do it, or draw up a simple table by hand. Keep copies of this information in your medicine cabinet, bedside drawer or kitchen-wherever you keep your meds-and give copies to your children and/or other caregivers. This spreadsheet is also a helpful document to take to your doctors visits. It gives them a quick, easy-to-read overview of all your medications.

None of us know how we will leave this world, but having the wrong drug cause it would be a stupid way to die, so please be vigilant. Take control of your healthcare. Remember, persistent and engaged patients get the health care they need and deserve.

-Andrew Schorr

Andrew Schorr is a 10 year leukemia survivor, entrepreneur, patient educator and patient advocate. He's also the founder and host of Patient Power®, the radio show. Every Sunday from 8-9 am on Seattle's 570 KVI he connects listeners live with leading medical experts and their patients to discuss topics such as how to find the right doctor, how to advocate effectively, when to get a second opinion from a specialist, and how to evaluate one treatment option over another. More than 100 hours of Patient Power® shows are also available any time at www.patientpower.info.