How to improve medication quality and reduce errors and costs

Chronis Manolis, Vice President of Pharmacy, UPMC Health Plan

One of the basic assumptions about health care is that patients take medications to aid care. However, there may be times when medication does not aid care, but rather, jeopardizes patient safety. Therefore, medication safety is an issue that should be taken seriously by health care professionals and patients alike.

According to the Institute of Medicine — an independent, nonprofit organization — at least 1.5 million Americans are sickened, injured, or killed each year by medication errors. The cost related to preventable errors has been conservatively estimated at $3.5 billion a year and does not include lost wages, decreased productivity and additional health care costs.

“Many medication errors are largely preventable,” says Chronis Manolis, vice president, Pharmacy, for UPMC Health Plan. “By improving patient education and putting the right programs in place, these errors can be reduced.”

Smart Business spoke with Manolis about patient safety in terms of medication and what can be done to improve medication quality and reduce errors and costs.

What are some examples of medication errors?

There are three general categories of medication errors: those related to prescribing a medication, those related to the dispensing of a medication at a pharmacy and those related to the use of a medication. For each category, steps can be taken by providers and patients to limit the occurrence of errors.

In terms of prescribing, a physician needs to have complete medical information about the patient when determining appropriate medications to not only treat a particular condition but to ensure that it will not be harmful. This information includes all medications the patient is taking, all laboratory test results, other physicians involved in the patient’s treatment, any past hospitalizations and any drug allergies the patient may have. It is critical that patients have their complete personal medical history and treatment information and make sure that this information is passed on to their physician.

Dispensing errors occur when patients receive a medication that was not intended to be given by the prescriber. Several factors contribute to this error, such as hard-to-read prescriptions, medications that have similar names or appearances, patients who have the same name as another patient and any communication barriers that may exist.

Lastly, patients may use a medication incorrectly or in error. Often, they do not understand which medications are to be taken, when to take them, what condition the medication is for, the importance of each medication, which medications interact with each other, or how to properly use the medications.

Because patients are central to many medication errors, significant effort is needed to improve knowledge, skills and motivation to use medications correctly.

How can patients become more educated about medication safety?

The path to better medication safety begins with increased knowledge. Understanding the specific condition and how it is being treated is an important first step.

Patients can begin by keeping a list of all the medications they take, including prescription medicines and over-the-counter medicines, vitamins, and herbs, and share this information with their physician. They should always communicate to their doctor any allergies or adverse reactions they have ever had to medications or other substances.

It is very important that patients understand everything about their medications. This includes why they are taking them, what side effects they may cause, how long they need to be taken and whether the medicine can be taken in conjunction with other medicines or supplements, such as herbs.

What are some additional tips?

Patients should discuss with their doctor all aspects of the condition that the medication is being used to treat. Also, patients should be able to read what their physician writes if they are given a prescription. Having one’s physician send the prescription electronically (if available) to the pharmacy can avoid handwriting challenges and drug name similarities, which will, in turn, improve safety.

Patients should never be afraid to ask questions if there are any doubts or concerns. They need to fully understand their role in their care. Most important, patients must know exactly which medications  need to be taken and when, and how often they need to take them. When a prescription is picked up at the pharmacy, they should ask if the medication being given is the medication the doctor prescribed and what exactly is the medication for.

What steps can be taken at the pharmacy?

Before leaving the pharmacy, always review medication and ask to speak to the pharmacist if there are questions or confusion. For example, if the prescription looks different, ask whether something has changed.

Patients should ask the pharmacist about any dietary restrictions, and whether there are restrictions with alcohol, or with other medications or over-the-counter supplements or herbs being taken. They should ask whether any drowsiness or dizziness can occur. Patients should request written information about the side effects and other warnings of the medicine. Written information has been shown to help individuals better recognize problem side effects. Lastly, using the same pharmacy whenever possible for all medications is another safety tip because the pharmacist will become familiar with the patient’s conditions and medication history.

Patients play a critical role in ensuring medication safety. Being actively involved in your own care enables the sharing of key information among all providers and thus promotes enhanced medication safety.

CHRONIS MANOLIS, RPh, is vice president, Pharmacy, for UPMC Health Plan. Reach him at (412) 454-7642 or [email protected]

Insights Health Care is brought to you by UPMC Health Plan