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with Rod Moser, PA, PhD

Stories from behind the examining room door, as told by Rod Moser, PA, a primary care physician assistant with more than 35 years of clinical experience.

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Monday, June 10, 2013

Avoiding Prescription Errors

By Rod Moser, PA, PhD

prescription

Medical providers often see a lot of patients. They see them quickly, bouncing from one examination room to the next. They prescribe over the phone and call orders in for patients in the hospital. They are definitely multi-tasking. In the old days of written prescriptions, the medical provider had a bit more time to think about what they were prescribing. They had to spell it correctly and write it legibly (sort of) for the pharmacist to interpret.

The pharmacist often had to decipher some squalling hieroglyphics in order to accurately dispense the medications written by the medical provider. Pharmacists also receive prescriptions over the phone, left on answering machines, or called in by medical assistants or office nurses who may not read them correctly.  There are tens of thousands of different medications with new ones released nearly every week; many with similar names and dosages.

Now, most medications are sent electronically to the pharmacy, either by computer or fax. This is supposed to reduce medical errors, but mistakes still happen. Medical providers will simply type the first few letters of a favorite medication, and it miraculously pops up on the screen. It may or may not be the correct medication. The dosages are often calculated by the computer based on your weight, or your medical provider will need to type in the preferred dosage and duration. Any allergies that are listed in your medical records should cause a warning if there is a conflict. The doctor must also send them to the correct pharmacy. If not careful, your prescription can end up at a pharmacy in a different state!

Mistakes happen more than you might realize. It happened to me.

I was being prepped for surgery. My IV was running and the nurse came in to inject an antibiotic. I had an arm band that listed my only allergy. As she pulled the cap off of the syringe and proceeded to inject it, I asked her what I was getting. She was about to inject the only drug that ever caused me to have a near-fatal reaction – one that caused an ambulance ride to the emergency room only a few years prior. The doctor knew my allergies, but yet ordered it. My chart had a red sticker with the drug listed as an allergy, and my name badge had it properly listed. Yet, no one but me noticed the error that was about to happen. What if I was not a medical professional suspicious enough to catch it? Each year in the US, over 98,000 deaths are attributed to medical errors. I could have easily been one of them.

Double-Checking your Doctor

  1. When your medical provider prescribes any medication, ASK WHAT IT IS. Get the name and write it down. Many doctors will mention brand names (easier), but yet prescribed a generic because of insurance reasons. If there are two names for the drug, write both of them down.
  2. Ask the reasons for the medication, unless it is obvious.
  3. Ask what dosage you are to take and how often. Inquire as to the duration you are to take it.
  4. Ask about any potential side-effects.
  5. Make sure your medical provider knows other medications you may be taking (including over-the-counter medicines), especially if you are seeing more than one doctor. Many drugs can have adverse interactions if taken together.
  6. If the medical provider gives you a written prescription, read it. Make sure it matches what he or she just told you. Unfortunately, many prescriptions use short-cut abbreviations in Latin. For instance, QID means “four times per day” and PRN means “as needed”. You may need to look up these meanings on the Internet or ask your medical provider before they take off to the next room. If the medical provider sends the prescription electronically to the pharmacy, you may need to address those questions later with the pharmacist.

 

As the patient, you have a personal responsibility to look up the medication you are taking and familiarize yourself with the usual dosages and usual side-effects.  Know what you are taking!

Double-Checking your Pharmacist

  1. When picking up your prescription, read the label carefully and make sure the medication prescribed by your medical provider matches the medications in the prescription. Ask the pharmacist if there is any discrepancy.
  2. If your medical provider told you to take the medicine for ten days, make sure there are ten days worth of medications in the bottle.
  3. Some medications are available in pills, capsules, or liquids, so make sure the type that was prescribed is in a form you can take.
  4. The pharmacist should give you a print out of patient information about the drug that was prescribed to you. If not, ask for it.
  5. If you think there is any type of medication error, bring it up to the pharmacist immediately.
  6. Make sure your allergy information is correct in the pharmacy computer and make updates as needed.

 

Preventing medication errors is a team effort and the most important member of this team is YOU.

Posted by: Rod Moser, PA, PhD at 10:56 am

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