Written by Garret Weigel
July 20, 2018
Written by Garret Weigel
It’s understandable that people who are admitted to hospitals should expect to return in better health, and that their prescribed medications improve their well-being. Unfortunately, this is not always the case despite the high standards that doctors are held to. The healthcare industry has been and always will be under scrutiny for rising prices, so any impact on reducing costs should be a welcome initiative.
Medication errors, defined as preventable events due to the misuse of medications, lead to 7,000 deaths each year, and cost nearly $21 Billion. This represents a substantial source of wasted spending in healthcare, one that can be reduced significantly to help with rising health expenditures. On top of rising healthcare costs, the United States has one of the highest rates of medical errors for adults with two or more chronic conditions in the world.
Healthcare is incredibly intricate, and medication errors are subject to this complexity. However, these errors can be categorized for more effective management. We’ll explore the leading causes of medication errors, and proposed solutions to prevent them.
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Medication errors can happen throughout the entire prescription regimen chain, from writing initial prescriptions to patients administering their own medication, both inside and out of the hospital. Many of the errors that occur can be broken up into 2 main categories: a lapse in communication and procedural issues.
Communication breakdown can happen in two separate cases: between doctors who are planning and prescribing medication, and between a doctor and a patient. Only 13 percent of primary care physicians reported that they communicated with a pharmacist regarding new prescriptions, contributing to the possibility of a mistake.
Ambiguities and misunderstood names can also lead to avoidable errors. Consider the drugs sertraline (ser-tra-leen) and cetirizine (seh-tare-a-zine). Sertraline, an antidepressant, and cetirizine, a seasonal allergy drug, have significantly different uses and can cause adverse effects in patients. Transcribing based on pronunciation can easily cause confusion, which is why it’s important for doctors to include the purpose of the drug when communicating verbally.
In addition to similar sounding names, medical abbreviations can cause confusion due to slight variations in letters. The abbreviation “q.a.d.” (quaque alternis die) refers to medication that should be taken every other day, while “q.a.m.” (quaque die ante meridiem) signifies that medication should be taken every morning. There are abbreviations whose letters are closer in relation, such as “o.d.” (oculus dexter) and “a.d.” (auris dextra) which refer to the right eye and right ear, respectively. A simple mix-up of letters can lead to medication frequency errors.
Only about half of patients who leave a physician’s office with a prescription take the drug as directed, leading to further complications with prescribed medication. The most commonly cited mistake with adherence to drug regimes was the frequency of dosing, again highlighting the importance of communication to ensure patients understand how to properly take their medication.
Patient misuse can also occur because of poor understanding of the directions for use. Unfortunately for some patients, prescription requirements can be complex and involve a variety of drugs and dosages taken at different intervals throughout the day. As the complexity of the regimen increases, the probability of medication errors increases as well, making communication vital in ensuring that medication is taken properly.
There has been a steady rise in price for vaccines, further increasing the costs of medication. Despite the unimaginable profits that pharmaceutical companies take in each year, new drugs have pushed up the average cost to fully vaccinate a child with private insurance to the age of 18 to $2,192 from $100 since 1986. This may cause more people who do not have insurance that cover vaccinations to opt out of vaccinating their kids, leading to additional increases in costs for issues arising from unvaccinated children.
Despite the many contributors to costs, there are a number of ways to prevent errors and ensure efficacy of medication. Doctors need to make safety a habit, part of their day-to-day work. Organizations like the Patient Safety Movement are working towards preventing medical errors at large. Their mission is challenging, but simple and achievable: zero preventable deaths by 2020.
Medical errors can also be reduced through embracing technological advancements in healthcare. Electronic medical record (EMR) systems can improve communication between doctors and their patients, replacing paper-based records that are prone to mistakes.
Accidental freezing of vaccines is a growing threat and a real risk for national immunization programs, highlighting the importance of a temperature monitoring solution throughout the medication cold chain. Ensuring efficacy of vaccines requires 24/7 monitoring so that temperature excursions can be managed before vaccine quality is degraded.
There are many contributors to the costs associated with medication errors, but most of these can be prevented through increased communication, improving on procedures that cause confusion or increase complexity, and implementing more robust technology.
Reducing healthcare costs and improving patient safety are initiatives SmartSense supports wholeheartedly.
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