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|Posted: Thu Jul 20, 2006 6:50 pm Post subject:
Report Finds Drug Errors Hurt 1.5 Million
Jul 20, 12:05 PM EDT
Report Finds Drug Errors Hurt 1.5 Million
By LAURAN NEERGAARD
AP Medical Writer
WASHINGTON (AP) -- More than 1.5 million Americans are injured every
year by drug errors in hospitals, nursing homes and doctor's offices,
a count that doesn't even estimate patients' own medication mix-ups,
says a report that calls for major steps to increase patient safety.
Topping that list: All prescriptions should be written electronically
by 2010, the Institute of Medicine said. At least a quarter of all
medication-related injuries are preventable, the institute concluded
in the report it released Thursday.
Perhaps the most stunning finding of the report was that, on average,
a hospitalized patient is subject to at least one medication error per
day, despite intense efforts to improve hospital care in the six years
since the institute began focusing attention on medical mistakes of
The new probe couldn't say how many victims of drug errors die. A 1999
estimate put the number of deaths, conservatively, at 7,000 a year.
Also unknown is how many of the injuries are serious.
But a preventable drug error can add more than $5,800 to the hospital
bill of a single patient. Assuming that hospitals commit 400,000
preventable drug errors each year, that's $3.5 billion - not counting
lost productivity and other costs - from hospitals alone, the report
"The numbers are big. The injuries are big. This is a problem, it's
serious and it continues," said report co-author Michael Cohen,
president of the Institute for Safe Medication Practices.
Technology alone could prevent some errors today, but there's too
little incentive for hospitals and other care providers to invest,
added University of Arizona pharmacy dean J. Lyle Bootman, who chaired
the IOM probe.
"We're paid whether these errors occur or not," lamented Bootman, who
recently experienced the threat firsthand as his son-in-law dodged
some drug near-misses while in intensive care in a reputable hospital.
For now, Bootman advises consumers to be aggressive in questioning
doctors, nurses and pharmacists about their medications, whether
they're watching over a hospitalized loved one or figuring out their
own pills at home.
How to battle drug errors is a particularly vexing issue because of
the sheer volume and complexity of today's medications. There are more
than 10,000 prescription drugs on the market, and 300,000
over-the-counter products. Many come with vastly different usage and
dosing instructions depending on the patient's age, weight and other
risk factors, like bad kidneys.
Plus, four of every five U.S. adults take at least one medication or
dietary supplement every day; almost a third take a least five. The
more you use, the greater your risk of taking two that interact badly,
especially if different doctors prescribed different drugs without
knowing what you already take.
But that's far from the only cause. Doctors' notoriously bad
handwriting too often leaves pharmacists squinting to determine if the
order was for 10 milligrams or 10 micrograms. Sound-alike drug names -
the hormone Premarin or the antibiotic Primaxin? - can confuse health
worker and patient alike.
There also are hospital mix-ups involving where a drug is
administered. Consider a rare but horrifying one: Accidentally
injecting the cancer drug vincristine into the spinal canal instead of
giving it intravenously is almost always fatal, and it's a slow,
painful death, said Cohen.
Moreover, the instructions given to consumers on how to take their
medicine is woefully inadequate, the report concludes. One study found
parents gave their children the wrong dose of over-the-counter fever
medicines 47 percent of the time.
Then there was the newly diagnosed asthmatic wondering why his inhaler
didn't work. Asked how he used it, the middle-aged man squirted two
puffs into the air and tried to breathe the mist. It turns out his
original doctor had demonstrated the inhaler without explaining that
to work, it had to be sprayed inside the mouth.
Among the report's recommendations:
-The government should take action to speed electronic prescribing,
including fostering technology improvements so that the myriad
computer programs used by doctors, hospitals and drugstore are
Fewer than about 20 percent of prescriptions currently are electronic,
Cohen said. E-prescribing does more than counter bad handwriting. The
computer programs can be linked to databases that flash an alert if
the prescribed dose seems high or if the patients' records show use of
another drug that can dangerously interact.
-Health workers must take steps to fully inform patients about
medication use, including checking every drug they use before
prescribing a new one.
-The nation should invest about $100 million annually on research into
drug errors and how to prevent them. Among the most-needed studies is
the impact of free drug samples, which often lack proper labeling on
-The Food and Drug Administration should improve the quality of drug
information leaflets that accompany prescription drugs, but often have
incomplete information or are written in jargon the average consumer
-The government should establish national telephone hotlines to help
patients unable to understand printed drug information because of
illiteracy, language barriers or other problems.
The Institute of Medicine is a branch of the National Academy of
Sciences, an independent organization chartered by Congress to advise
the government on scientific matters.
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