It’s a troubling paradox. As medication breakthroughs offer new hope for treating disease, medication errors are harming more and more Americans. On the plus side, the treatment of virtually every major illness has been revolutionized in recent years by the advent of better agents. Take diabetes. Not so long ago the only drug treatment options were insulin and a handful of fairly primitive oral agents. Today physicians can choose from at least five different classes of pills and ten insulin formulations. At the same time, scientific studies clearly demonstrate that aggressive treatment greatly reduces diabetic complications. Thus diabetes today is often treated with combinations of two or more complementary drugs.
The same is true of many chronic disorders common in our society, especially among older adults. Hypertension (high blood pressure), coronary artery disease, arthritis, cancer, hyperlipidemia, depression and many other disorders are now routinely treated more vigorously and with more drugs than ever before. According to the Henry J. Kaiser Family Foundation, there were over 3.6 billion retail prescriptions written in 2009 in the U.S. Seniors, who represent 13% of the population, account for 31% of these prescriptions. According to Georgetown University’s Center on an Aging Society, individuals between 65 and 79 years of age receive an average of 20 prescriptions each year.
But there’s a downside to all this: along with the proliferation of drug treatments there has also been an upsurge in so-called medication errors. One reflection of the problem is the high frequency of discrepancies between what patients are actually taking and what their doctors’ records indicate. An often-cited report published in the Archives of Internal Medicine in 2000 revealed such discrepancies in fully 76% of the patients studied. One big reason is poor communication between patients and health professionals. Another is the woefully inadequate record-keeping in our fragmented health system.
Improper use of medications can cause harm as the result of dangerous side effects, drug interactions or inadequate treatment. Medication errors can be thought of as falling into three categories: overuse, underuse and misuse. Taking medications inappropriately (misuse) or excessively (overuse) can of course lead to preventable side effects. But underuse may be just as serious, because patients thereby lose the benefits that state-of-the art treatment can offer.
Medication errors take a staggering toll in terms of complications, preventable hospitalizations, inadequate treatment and even death. A 2006 report from the Institute of Medicine indicated that at least 1.5 million Americans are harmed every year due to medication errors, costing billions of dollars annually.
Medication errors can be prevented. Here are a few suggestions:
- Be an active participant in all treatment decisions. Make sure you understand why a given drug is being prescribed, how to take it safely, and what side effects are possible.
- Keep careful track of any allergies or previous adverse effects from drugs.
- Bring all medication bottles, prescription and non-prescription, to every visit with a health professional–even if you are not asked. Have someone go over your medications and check for any discrepancies with the medical record.
- If you didn’t follow instructions for whatever reason, say so. Don’t leave your physician with the impression that you’re taking a medication if you’re not.
- Don’t “self-prescribe” over-the-counter drugs for chronic conditions. The drugs approved for over-the-counter use in recent years are more powerful than ever. Besides causing potential serious side effects independently, they may interact adversely with prescriptions you are taking.
- Use a pill dispenser if you have problems remembering to take your medications at the right time. There are many excellent designs available.
- Ask your physician if a consultation with a pharmacist is covered by your health plan. Pharmacists have been playing a larger role in the health care team in recent years.
- If a doctor advises you to change a medication that another doctor prescribed, satisfy yourself that they have communicated with one another about the change.
- Keep an accurate and current list of all your medications readily available at all times. Include any medication allergies or intolerances. In an emergency, this simple practice can be life-saving.