Medication errors and prescriptions: a dangerous trend

medication errors

In an age where breakthrough drugs are constantly being developed and discovered, popping a pill or two often seems to be the most sensible solution to any malady. Many physicians and nurse practitioners (prescribers) are quick to prescribe multiple pharmaceutical drugs to solve or reduce the health issues faced by their patients–and the patients, of course, are eager to take them. It is undeniable that prescriptions are helpful in numerous medical situations, but it cannot be ignored that millions of these prescriptions are given in the wrong context. The reliance of prescribers and patients on prescription drugs often leads physicians to overprescribe and misprescribe medications, a mistake that can have dangerous outcomes.

It is estimated that 3.4 billion prescriptions were filled in the United States in 2003, which averages to 11.7 prescriptions per citizen. The enormous quantity of medications distributed each year translates to an inevitable number of misprescriptions–prescriptions that are inappropriate for a particular ailment and may be downright dangerous for a patient to take. A 2004 study found that 1 in 12 doctor’s visits in the U.S. resulted in the patient receiving misprescribed medications.

When misprescribing and overprescribing occurs, the negative effects range from simply not solving the health issue in question to actually worsening the condition. An over-prescription of anti-depressants, for example, could have reverse effects on a patient with depression. Misprescribing drugs could mean that the prescribed drug would pose a health threat. Prescribers advise not to take medication when one is not ill; thus, the dangers of prescribing something that shouldn’t be prescribed are clear. There is also a vast amount of money that is wasted when misprescriptions occur, a devastating dilemma for those who pay for their own medications or have expensive copays.

Healthcare providers may misprescribe for a number of reasons. The drug industry is a driving factor behind this persistent issue. Advertisements provided by drug companies promote certain medications to the point where patients request them by name, often leading prescribers to tailor their prescriptions around the patient’s wants rather than medical necessity. Additionally, the dangers of mixing certain medications are not always widely publicized and discussed. Prescribers may not ask for adequate background information from their patients, a vital step in determining whether a patient should add a new medication to what they are currently taking. Furthermore, research has shown that some doctors–particularly those who are ACoAs (adult children of alcoholics)–feel the pressure to please their patients and will act according to their patients’ requests.

“With doctors stretched thin, some […] think writing prescriptions is the easy way out,” states an article about the stress of the medical community over misprescribing pain medications and other pills. Healthcare providers oftentimes go straight into prescribing another medication when the “disease” for which it is being prescribed is in fact a side effect of a drug that the patient is already taking. The professional will prescribe a drug to “treat” what is actually an adverse reaction to another medication, which could have been more effectively solved by lowering the dosage of the initial medication or replacing it with another form of treatment.

Due to adverse reactions to misprescribed and overprescribed pills, half a million people are hospitalized each year. The medications they are misprescribed lead them to experience reactions that could have been avoided had the pills been properly prescribed or not prescribed in the first place. Mistakes happen even in the realm of medical science, but prescribers must take more careful measures before issuing their patients a prescription. By exerting greater care in the issuing of medications, misprescriptions can be avoided.

This guest post is contributed by Adrienne Hurst at AllTreatment.com, a rehab center directory and substance abuse information resource.

Comments: Attorneys and their experts who evaluate the liability and damages issues surrounding prescriptions should consider:

  • Was the condition accurately diagnosed?
  • Was the prescription an appropriate treatment?
  • Was the drug prescribed in the correct dosage and route?
  • Was the drug being used off label or in an unapproved manner?
  • Did the patient have contraindications for the use of that drug?
  • Did the patient provide appropriate informed consent regarding the drug, as well as receive education on uses and side effects?
  • Was the patient’s condition monitored for therapeutic response to the drug?
  • Were side effects promptly recognized?
  • Did an error in prescribing cause any permanent injury?
  • Careful analysis of the medical record, with the assistance of a legal nurse consultant, can make all of the difference in the outcome of a case involving misprescription.

    Sources:

    http://www.worstpills.org/public/page.cfm?op_id=3

    http://www.e-tmf.org/downloads/Why_Physicians_Misprescribe.pdf

    http://www.in-pharmatechnologist.com/Packaging/No-improvement-in-misprescribing-rates

    http://sundaygazettemail.com/News/201101161143?page=2&build=cache

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    3 Responses to Medication errors and prescriptions: a dangerous trend

    1. oscar perera says:

      Once upon a time medications errors (was a simple equation) and an issue equivalent to excess volume versus small workforce ( a lot of patients and not enough providers to assure safety). Now, with high technology applied (we can do high volumes, and the small work force is subjected to work force optimization metrics) so we can do high volumes (with high technology) while the workforce have time to take care of patients. But….. beware…. since the science of workforce management (human capital optimization) is also now very technological advanced. Now physicians are given handling times (by QA depts. that are not physicians) as for example (15 minutes average handling time to see each patient!) and pharmacists are given (in central operations central fill) 13 seconds to review prescriptions, and 8 seconds to review clinical interactions. Pharmacy technicians are given 35 to 45 seconds to enter Rx data, and 9 seconds to review doctor-patient verification. With the latest trends in human capital optimization (where people are machines that are assignned handling time metrics to practice medicine) if applied to medicine (already been applied extensively in the last few years) could have detrimental consequences in the creation and proliferation of errors ( in the name of QA by non-medical professionals performing workforce management work). Imagine a by-pass heart surgery, performed with handling time metrics were the thoracic surgeon is given specific handling times to perform vein graft from the leg to be transplanted into the coronary artery. This type of metrics (at the operating room level) is not happening yet, however it is a wake up call for all patients and for lawyers in the personal injury and malpractice field. However, this type of metrics control ( handling times) is imposed to the medical practitioner by non-medical workforce management (“quality assurance” departments) operatives in the name of workforce optimization in order to offer “QUALITY” while optimizing “human capital”.

    2. OSCAR PERERA-MONTANES, RPh, MBA says:

      Oscar Perera-Montanes , RPh, MBA is a clinical pharmacist/informaticist with an MBA in Management of Information Systems from City University of Seattle. Perera is a former USPHS/HHS civil service medical provider specialized in advanced EHR, virtual pharmacy and e-prescribe systems, and a former Walgreens CPO Central Pharmacy Operations pharmacist in Orlando, Florida.

    3. OSCAR PERERA-MONTANES, RPh, MBA says:

      Dr. Oscar Perera-Montanes, RPh, MBA is also an advanced pharmacist practitioner with a Florida Pharmacist Consultant License (CPh). Perera is also a researcher in several professional fields such as clinical pharmacy and therapeutics and graduate management science researcher and specialist. Other areas of practice are: Management Consultancy, Healthcare/Pharmacy informatics, MIS (advanced Management of Information Systems). Presently, Perera is a clinical pharmacist practitioner for Humana Health Plans, South Florida.

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