This is a true story.
Yesterday, I picked up a new recipe of antibiotic for my daughter in my local pharmacy.
(We recently adopted my daughter of the India where he had recurrent ear infections resulting in severe hearing loss). (And she is about to undergo the second of several planned surgeries in an attempt to repair the damage.)
Before put to sleep, he left the new drug of the bag, he looked at the instructions and prepared to give the medication according to the instructions on the label.
Just before doing so, I had a quick double-take.
Something seems wrong. I looked at the instructions again and slowly, thought * it * s happening... This * t think right.* then, hit me the dose seemed terribly high for her.
It took me a minute or two to put the pieces together (it had been unusually heavy fighting him preparing for bed, I was tired, I trusted my daughter * s medical and I was thinking perhaps less critically that I have). And then I noticed. The label had a stranger * name s.
After another moment or two, I saw what had really happened.
Medication entered into a table. Each side of the box had a different label... a label was for my daughter and a label for a stranger. And the stranger * s dose was more than twice as much as my daughter * s surgeon had recommended.
(This error * t happens in a homemade pharmacy.) (It happened in a pharmacy in modern new chain whose name would recognize ad on TV.)
I * m not a surgeon... and I * m not a paediatrician... but I'm a doctor trained in internal medicine and I have spent most of the last twelve years writing about speaking and development of systems to reduce the frequency of medication errors and improve the safety of the practice of pharmacy.
This pharmacy error brought the issue of the safety of drugs home for me... literally.
What I can tell you is that this type of error occurs all too often in the United States (and worldwide). And you can have devastating consequences for the people involved.
A recent study in the New England Journal of Medicine indicates that 25% of patients taking one or more prescription medications will experience an adverse event within three months--and 39% of these are preventable or avoidable.
The Harvard Medical practice study found reported in JAMA in 2001 that 30% of patients with drug-related injuries died or were disabled for more than 6 months.
And what almost everyone who studies accepts this problem is that current systems to select drugs, them, communicating a prescription at a pharmacy, drug dispensing, dosing teaching patients about their safe use are woefully inadequate.
In this series, let's take a close look at the processes that cause medication errors (some things your doctor and pharmacist may not even want you to know) and what measures can be taken specifically to make sure that you and your love are protected from this threat.
Ten years ago, your ability to get current, objective, accurate information about their drugs's fast and easy way was practically non-existent. It would have probably involved a trip to the library and requires considerable knowledge of Pharmacology for the answers.
Today, that * s is not the case. There are a lot of tools online, databases and resources to obtain information about medicines that even your doctor and pharmacist may not know.
We * re going to talk about them, show off to go tell them the key things you need to know about drugs, exposing some myths and let you know the questions you should ask. It * s not as difficult as it may seem.
In fact, it needs to become the last line of defense in the battle against medication errors.
Throughout, we will give you some basic rules that should guide their defense.
Thus rule number 1. Trust, but verify. Never assume that the medication is dosed correctly for you or it has received the right medication for you. Specifically, you should check:
the name of the patient in the bottle;
the name of the doctor in the bottle;
the name of the medicinal product (and cross check to make sure that is a problem or a disease actually have... There are many names of drugs look alike/sound alike out there);
dose (an independent source... to make sure that it is a plausible dose for you);
the * path * (to ensure, for example, be prescribed eyedrops for eye and no mouth or ear... amazingly drug loss injuries occur all the time);
the expiration date.
We * ll talk about some specific resources that will help with each of them throughout this series.
The result, hopefully, will be the piece of knowledge that you and your family are receiving their 7 rights:
drugs right;
correct patient;
correct dosage;
right time;
correct path;
right reason;
correct documentation.
In!
© 2004 Timothy McNamara, MD, MPH
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