बुधवार, 7 मई 2014

A little knowledge about the drug you are using can ensure that you don't fall prey to medication errors.

A little knowledge about the drug you are using can ensure 

that you don't fall prey to medication errors.

Are you taking the right pills?

I believe that the doctor who orders, the pharmacist who dispenses, the nurse who administers or the patient who accepts the drug should be held responsible for medication errors leading to complications

A medication error is any preventable event that may cause or lead to inappropriate medication use or harm patients while the medication is in control of the healthcare professional, patient or consumer. According to the National Co-ordinating Council of Medication Error Reporting and Prevention, this may also involve ordering, prescribing, distributing, labeling, administrating, monitoring and using. One must differentiate between adverse drug reactions, drug interactions, and prescription errors.


So a little knowledge about what a drug does goes a long way. It is wise for patients to determine the generic name of a drug that has been prescribed to him -- for what it is being used, what side effect are possible, and what the recommended dose is and for how long it is to be taken. It may be also important to ask what you should do if you miss a dose and will it interfere with any medication you are taking. An estimated 1 million medication errors occur every year that contribute to 7000 deaths.

A colleague of mine was once perplexed because his patient had become semi-comatose. It was later found out that instead of a digestive tablet, he was given an anti-diabetic drug of similar sounding name. Hence his sugar level had become extremely low and he had become semi-comatose. This, in my opinion, was a drastic error. It left one lesson in my mind that when I find a patient not doing well, I pick up and examine the medication that he has with him to ensure that he is taking the right medicines. Unfortunately in this city there are no pharmacists in chemist shops and the shops manned by people with little education. Many of them pass of similarsounding drugs as the same drug, a drastic and even fatal mistake at times.

Many hospitals have used computerised physician order entry. Such system reduces medication errors by 85%. In such instances when a physician orders medication, the computer checks the safety and appropriateness of the order and it is electronically sent to the pharmacy. This curbs the need of the pharmacist. It is also helpful because doctors who write prescriptions usually have horrible handwriting. For example, I myself get at least 2 calls a week from chemists, who are unable to read my handwriting.

I had once asked them whether they face this problem on a daily basis, or is my handwriting the worst - absolutely illegible -- they said that this is a perennial problem that they deal with.

A study done in 2010 and published in the prestigious New England Journal of Medicine said that 25% of patients are harmed by medical care. Another study published in Health Affairs in 2011 stated that the standards hospitals used to detect medical errors fail over 90% of the time. Approximately, 1.3 million people are injured annually in the United States following medication errors.

People above 60 years are mostly affected by fatal medication errors. This is not surprising because they take multiple medications. In 2006, a study by Institute of Medicine Study stated that medication errors are among the most common medical mistakes.

According to this study, 4,00,000 preventable drug-related injuries occur each year in hospitals; 8,00,000 in long term care and roughly 5,30,000 among medicare recipients in out-patient clinics. In a single year, the extra medical costs by preventable drug-related injuries, is approximately $887 million.

I believe that the doctor who orders, the pharmacist who dispenses, the nurse who administers or the patient who accepts the drug should be held responsible for medication errors leading to complications. A little care from everyone will help prevent drug related disasters.

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