Drug Confusion: More Doctors, More Opportunities for Medication Mistakes

Theresa Brown, a home hospice nurse penned an article this month for the New York Times in which she described the need for a universal medication list for every patient in America, backed up with her own experience having rarely received a 100% accurate patient drug record, as well as statistics that show medication errors are alarmingly prevalent.

For Now, Patients in Charge of Their Own Medication Lists
Theresa Brown cites a 2010 study by the Journal of Geriatric Internal Medicine in which it was discovered that 309 medication errors existed in a sample of 651 hospital patients. More than half of these errors had the ability to cause side effects for the patient. The problem is that as patients, we see multiple health care providers throughout our lifetime, from a primary care doctor, to a provider at a hospital or urgent care, to a gynecologist, dermatologist, cardiologist, oncologist, or gastroenterologist. We’d like to assume that our health care provider has a detailed history of all of our medications, previous surgeries, and ailments each time they see us, but that couldn’t be further from the truth. Not all electronic medical record (EMR) systems are connected and a primary care doctor might not have any information from a gynecologist or dermatologist, much less the drugs you’ve been prescribed.  A medication prescribed by one provider may not interfere with a drug prescribed by another, but it could. Even failing to give the doctor information about herbs, vitamins, or supplements you’re taking can impact the efficacy of a drug and could leave you missing out on important information regarding interference.

Patients Should be Patients, Not Physicians or Pharmacists
Ms. Brown describes how patients often have come to her with baggies of pills, saying they only know the drugs by color and what time of day they’re supposed to take them. They’re unsure of the name of the drug, its purpose, or who prescribed it. This obviously presents challenges, but it’s also asking the patient to take on a role they’re ill-equipped for. Patients are not health care providers or pharmacists and shouldn’t be expected to interrupt their doctor to say that they’re taking a blood pressure pill, for example, and ask how that might interact with a new medication they’re being prescribed. The solution, she believes, is a universal medication tracking system that exists in the “cloud.” A patient-driven, entirely voluntary program, she says that buy-in from the Centers from Medicare and Medicaid (CMS) would encourage hospital systems and physicians’ offices to strictly adhere to the program to avoid penalties or receive incentives. For now, no such system exists, but if Ms. Brown’s idea gains momentum, she just may be onto something that can prevent millions of Americans from unnecessary harm.

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