How to Reduce Your Risk of Medication Errors
Wednesday, May 7th, 2008 
Consider the following scenarios: A hospital nurse grabs the wrong vial of medication to administer to a patient — a potentially life threatening mistake — because the packaging closely resembles that of the correct medication stocked one shelf over. A doctor’s illegible handwriting results in a pharmacist misreading a medication order and filling it with the wrong medication. A patient fails to notice his prescription for Clonidine, a heart medication, is filled as Colchicine, a medication for gout, because the drugs have names that look alike and sound alike — a problem for more than 1,400 commonly used medications because brand and generic names are dangerously similar to others.
Each of these is a type of medication error, which occurs every day in hospitals, doctor’s offices, pharmacies and people’s homes, and which kills more people than AIDS, breast cancer and traffic accidents. According to the Institute of Medicine, between 44,000 and 98,000 Americans die each year due to preventable medical errors in hospitals — just one setting where medication errors can occur.
Medication errors are made by a variety of people, and occur for a variety of reasons at any time throughout the medication supply and use chain. “The person making the error can be a health professional, or it can be a patient or caregiver,” explains Diane Cousins, R.Ph., vice president of healthcare quality and information for the U.S. Pharmacopeial (USP) Convention, a non-profit group that sets the official quality standards that prescription and over-the-counter medications in the United States are required to meet.
“These mistakes can lead to a severe deterioration of a medical condition or even death, and they contribute to the rising costs of medical care in the management of these mistakes,” says Cousins. “But while the fear of a medication error can make patients feel helpless, it is important for people to know that all medication errors are preventable and that patients have an important role to play in keeping their care safe.”
The USP recommends these steps to reduce your risk of harmful medication errors:
Before you leave the doctor’s office:
Make sure you understand why you are taking a medication, how it is supposed to help your condition, and how to pronounce both the brand and generic name of the drug. A key action a patient can take to prevent an error is asking the doctor to write the “indication for use” on the prescription order. This is a statement that identifies what the medication is being taken for — words such as ‘for cough,’ ‘for allergy,’ or ‘for heart.’ This is not the diagnosis, which could violate patient privacy laws, but the symptom the medication is treating. If a doctor’s illegible handwriting leads to a misinterpretation of the prescription, the indication for use can alert the pharmacist that something isn’t right. For example, if the indication says the prescription is for the heart, the pharmacist is more likely to notice that he or she is incorrectly dispensing a medication for gout. In addition, when the indication for use is written on the doctor’s prescription order, it will always be printed with the directions on the prescription label, reminding the patient of what condition the medication is being taken for.
At the Pharmacy:
Take advantage of patient counseling from the pharmacist. This key individual in the treatment chain is often overlooked — and he or she is one of your most valuable resources. Ask about potential interactions with other drugs or dietary supplements, as well as instructions for use — for instance, does three times a day mean take with breakfast, lunch and dinner, or every eight hours?
At home:
Read the instructions and information packet carefully and always double check to make sure you grabbed the right bottle of medication from the medicine cabinet. Many errors at home involve taking the wrong dosage or taking the wrong drug. The indication for use is an important clue to the medicine that is in the container. Children and the elderly are particularly susceptible to harmful results from these types of errors, as an overdose is more likely for someone of low weight and a mix-up is common among older people taking multiple medications. It is also important to keep an updated list of all medications you are taking (including over-the-counter drugs and dietary supplements), and sharing this list with a family member or other caregiver. Should you be hospitalized and unable to communicate the medications you are taking, this list is a very important tool to your emergency care.
In the hospital:
As noted, always have your list of medications available in case of emergency hospitalization. If you have a planned visit to the hospital for a surgery or other purposes, bring someone you trust to serve as your advocate. This person should communicate with doctors and nurses, asking why you are being given a certain medication. Make sure this person knows to take a second look at what a nurse or doctor is giving you and stands ready to ask questions — it could be a life-saving question.