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MEDICATION ERRORS ON THE RISE:
Are You Taking Your Medication Correctly?

Joanna Hayden, PhD, CHES

Using data from national Poison Control Centers, researchers analyzed the more than 67,000 reports of medication errors occurring outside of a health care facility between 2000 - 2012 and found the rate of serious medical consequences doubled during this period. The greatest number of errors involved cardiovascular medications and the greatest number of deaths were from pain medication errors. This study was published last week in the journal Clinical Toxicology.

Full journal article: http://www.tandfonline.com/doi/full/10.1080/15563650.2017.1337908

Use this News

According to a 2016 CDC report,  almost half (48.9%) of all Americans take at least one prescription drug and about 12% take more than five. With people taking more medication than ever before, medication errors are on the rise. To put the problem in perspective, the National Academy of Sciences - Institute of Medicine estimates that at least 1.5 million preventable medication errors occur each year, or about 171 per hour. While the majority occur in health care facilities (nursing homes, hospitals, etc.,) 93% of the errors analyzed in this study, occurred at home.  The most common medication error at home was taking/giving an incorrect dose, followed by taking/giving the medication twice, taking/giving someone else’s medication, and taking/giving the wrong medication.

Medication errors can have very serious consequences especially so with errors involving blood thinners, pain medications and cancer treatments.  About a third of those in the study above were admitted into the hospital for treatment as a result of the error, including intensive or critical care for 17% of them. For 414 people, the medication error resulted in death.

Below are some tips for preventing medication errors:

  • If you take/give a number of medications everyday, keep a written record of the time you  take/give them
  • If more than one person in the house takes medications: 
                o   get different color organizers for each person
                      and put their names on them.

                        o   color code the pill bottle caps with permanent
                              marker (ex. blue for dad, pink for mom, green for
                              granddad).
  • If you have trouble swallowing a large pill, ask if the medication can be made as a liquid rather than trying to cut a pill in half.
  • Ask the health professional giving you the prescription to print on a separate piece of paper, the name of the drug, why you are taking it, how much you are to take and how often. When you pick up your prescription, check it against what you have written.
  • When you pick up your prescription, ask the pharmacist what you should do if you miss a dose.
  • Make sure of the dose before leaving the pharmacy. Is it the whole pill, half a pill or two pills.
  • Know the generic and brand names of any new medication so you can check to see if you are already taking it under a different name. (For example, the heart medication Lanoxin is the brand name of digoxin –they are the same medication. Coumadin and warfarin sodium are the same medication used to prevent blood clots).
  • If the prescription is liquid, use the measuring cup that comes with it.  Do NOT use spoons from your kitchen.

If you take or give an incorrect dose, incorrect medication, take/give the medication twice, give the wrong person medication, or make any other medication error, call Poison Control immediately.

                                             Poison Control
                                
1-800-222-1222


For more information:

Preventing medication errors
National Academy of Sciences – Institute of Medicine
http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2006/Preventing-Medication-Errors-Quality-Chasm-Series/medicationerrorsnew.ashx

How to prevent medication errors
Institute for Safe Medication Practices
https://www.ismp.org/pressroom/Patient_Broc.pdf

Strategies to reduce medication errors
FDA
https://www.fda.gov/Drugs/ResourcesForYou/Consumers/ucm143553.htm

Taking medication safely
National Institutes of Health – senior health
https://nihseniorhealth.gov/takingmedicines/takingmedicinessafely/01.html

Medication safety basics
Centers for Disease Control and Prevention (CDC)
https://www.cdc.gov/medicationsafety/basics.html

American Association of Poison Control Centers
http://www.aapcc.org/

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MOST OF US DON’T HAVE ADVANCE  DIRECTIVES …AND WE SHOULD
Joanna Hayden, PhD, CHES

After researchers reviewed data from 150 studies conducted on almost 800,000 people between 2011- 2016 they found that only 36% had completed advance directives and for 29% of them, it was a living will. The results of the study were published last week in the journal Health Affairs.

Article summary: https://medlineplus.gov/news/fullstory_167074.html
Journal article abstract: http://content.healthaffairs.org/content/36/7/1244.abstract

Use this news

Advance directives is not a comfortable topic of conversation for many people. So, the low rates of completed documents found in the study above comes as no surprise.   An advance directive is an umbrella term that covers different types of written, legal documents used to guide your health care if you become incapacitated. The two main documents are a living will and medical power of attorney. Other advance directives can include documents for do not resuscitate orders, organ donations, feeding tube insertion, and blood transfusions.

To help clarify the differences between the most important of these document -

A Living Will is a written legal document that informs medical personnel of the types of treatment you want if you are dying, unconscious, or otherwise incapacitated and cannot make emergency health care decisions. A living will indicates your wishes about being resuscitated, put on a ventilator, or having a feeding tube inserted.

A Medical Power of Attorney  or health care power of attorney is a written legal document that specifically names someone (called a health care proxy, surrogate, or health care agent) to make medical decisions for you at times when you are not able to make those decisions for yourself. The person you choose will be speaking for you should the situation arise, so he/she should know what you would want done. A medical power of attorney covers more than a living will does, so it can be used instead of, or in addition to a living will.

Having a medical power of attorney is not just for older people or people with life threatening illnesses. It is particularly important for parents when their children turn 18. Once a child turns 18, he/she is legally an adult. With this birthday, parental rights to medical information and to make medical decisions, vanish. What this means is - if your 18 year old child is lying in an emergency room, you have no right to any information about his/her condition or any right to make medical decisions. HIPPA privacy rules in fact, make it illegal for medical personnel to share information with you once your child turns 18.

Other documents

DNR – Do Not Resuscitate – informs medical personnel that you do not wish to have your heart
“shocked” or restarted if it stops beating or is beating so abnormally that it is life threatening.

Organ and tissue donation - informs your family/significant others and medical personnel of your wishes to donate organs or tissues for transplantation.

Durable Power of Attorney – gives someone else the power to conduct your business on your behalf. For example, sign checks for you to pay bills, sign tax returns, access your bank account.

There are a number of websites with “do it yourself” legal forms, including those for advance directives. Just make sure you use the ones for your state and follow the instructions exactly. Given the complexities of the law and minor nuances of each state, a better option is to seek out the services of an attorney who specializes in elder law, even for your 18 year old’s medical power of attorney.  The emergency room is the last place you want to find out that the document you have is useless.

For more information

NIH – National Institute on Aging
Advance Care Planning Tips
https://www.nia.nih.gov/health/publication/advance-care-planning

Mayo Clinic
Living wills and advance directives
http://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/living-wills/art-20046303?p=1

AARP
Advance directive
http://www.aarp.org/relationships/caregiving-resource-center/info-11-2010/lfm_living_will_and_health_care_power_of_attorney.html

HIPPA
https://www.hhs.gov/hipaa/index.html