Prescription Drug Errors

It’s time to stop joking about doctor’s poor handwriting and illegible prescriptions—way past time: Those illegible scribbles are killing people.

When your doctor writes you a new prescription, make sure you can read the name of the drug. If you can’t, ask the doctor to write it again, or spell it for you so that you can write it down. Also make sure your doctor explains what the medication is for, so that if the pharmacist hands you a sleeping pill instead of the anti-depressant you were expecting, you will know that a mistake has been made.

Get all your prescriptions filled at the same pharmacy, so that the pharmacist can watch for drugs that shouldn’t be taken together. When you pick up a new prescription and the pharmacist offers you a consult, don’t wave him or her away. Listen to the consultation. If the pharmacist’s instructions are different from your doctor’s, ask questions. You should also receive a printed information sheet for any new medication you are taking. Read it.

For refills, open the bottle right at the counter and make sure the pills look familiar (some good pharmacists do this for you). If not, speak up.

Also, every so often, I scoop up all my prescription medications (I have between four and eight at any given time) and take them with me to my regular checkup with my medical oncologist. We go over the drugs to make sure that he knows everything I am taking and that I am using them correctly.

There is a lot of debate about the use of alternative medicine in cancer treatment, including antioxidants. I am not wading into that debate except to say: Consider any supplements, herbs, or vitamins you are taking to be drugs. Get your doctor’s approval before starting any supplements, and tell your pharmacist what you are taking. Interactions, including some that may interfere with your conventional treatment, are possible, and not everything “natural” is safe.

When you travel, carry a list of all the medications you are taking (drug name and dose), as well as any allergies you may have. This list should also include the condition or conditions you are being treated for, and the treatments you have had. A former emergency room doctor tells me that this is especially important for elderly people, who get in trouble more often while traveling and who often can’t give a good medical history off the top of their heads.

I know the feeling--I can't give a coherent summary of my medical history and the drugs I am taking when I'm stressed either.

Update, January 26, 2007: According to an article in the January/February issue of AARP magazine, you should avoid going to the pharmacy during the first week of the month. "That's crunch time for drug dispensers, with a surge on new and refill medications for those who just received their Social Security checks--and it's the time when the risk of death caused by drug errors is at its peak."

The magazine doesn't cite a source for that last disturbing piece of information, so I hope this is not just another urban legend. But it makes sense that errors would be more common when the pharmacists are slammed, so something worth considering.

@ Jeanne Sather 2006

Comments

[Kate Gladstone]

As a handwriting instruction/improvement specialist, I make about 80% of my income from hospitals that call me in to prevent medication errors (by giving handwriting classes to the doctors. Among these hospitals, a fairly high percentage claim to have “computerized everything” 1 or 2 or 5 or more years ago … yet they tell me they still have handwriting problems, because of a crucial 1% to 5% of handwritten documentation that just won’t go away. Doctors in “totally computerized” hospitals still scribble Post-Its to slap on the walls of the nurse’s station, still scrawl notes on the cuffs of their scrubs during impromptu elevator/corridor conferences with colleagues … and, most of all, doctors with computer systems often have the ward clerks operate the computers, use the Net, or whatever: working, of course, from the doctors’ illegible handwriting. Bad doctor handwriting, incorrectly deciphered by ward clerks using the computer for any purpose, therefore remains part of the medical record. And what happens when disasters like Hurricane Katrina knock out a hospital’s network? More than one hospital, during Katrina, lost its generator, its electric power — and therefore its computer system — for the duration. Even the computer-savviest staff at these locations therefore had to return to handwriting. Kate Gladstone - Handwriting Repair - http://learn.to/handwrite

[Jeanne]

Kate--this is fascinating. Would you be available to do an interview so that I can write a longer piece about what you do to post on my blog, and perhaps to publish elsewhere as well?

Let me know.

Jeanne
jeanne.sather@gmail.com