Drug Errors Persist Despite Computerized Prescriptions – How To Protect Yourself

Reading prescriptions, and other doctors’ notes, makes you wonder if doctors attend special handwriting classes that make it virtually impossible for someone to read what they’ve written. As a result of doctors’ notoriously bad handwriting on prescriptions, patients sometimes get the wrong drugs, wrong dosages and wrong schedules – which can have dangerous and sometimes fatal consequences. In an attempt to remedy that situation, many doctors now use a computerized system that is supposed to take the guess work out of filling prescriptions. However, a new study shows that using computers didn’t improve the situation – just as many medication errors are being made as before.

To determine the success of computerized prescription systems – known as e-prescribing – analysts reviewed 3,850 prescriptions received by three major pharmacy chains in three states  over a four-week period. They found errors in 11.7 percent of the total – not much different than the errors in the hand-written variety.

Of the prescriptions with errors found, one-third could lead to dangerous drug reactions or interactions.

Most of the errors involved prescriptions for antibiotics, nervous system, respiratory and cardiovascular medications. The errors on antibiotics were most likely to cause adverse reactions and interactions.

The most common error, found in nearly two-thirds of the cases investigated, was omitted information – e.g. nothing on the prescription about the dosage, how often the patient should take the medicine, or for how long.

Not all e-prescribing software gets the same results: error rates ranged from 5.1 percent to 37.5 percent, depending on the software functionality. For example, software that forces a doctor to fill in required fields – like the dosage, frequency and duration –  in order to be able to generate the prescription at all would reduce the error rate and, in fact, eliminate most of the problems.

As of 2009, doctors who use e-prescribing receive bonuses of 2 percent of the amount they bill to Medicare in any given year. Computerized systems were supposed to save $ billions in healthcare money. Instead, hundreds of millions are being paid in bonuses – with no change in the cost of prescription drug errors to taxpayers, or the dangers to those taking the drugs.

Medical errors, including the errors e-prescribing were supposed to correct, continue to play a huge role in rising healthcare costs, but when it comes to prescriptions, patients can protect themselves by verifying the following information whenever their doctor wants them to take medication:

• The name of the medication
  
• The strength of each pill – e.g. number of milligrams
  
• What the drug looks like (to avoid getting the wrong medication – another error)
  
• How many pills they’re supposed to take with each dose, when each dose should be taken, and the number of days they’re supposed to stay on the medication
  
• Is there anything in their medical history that could be reason to not take the drug?
  
• Are the doctor and pharmacist fully informed about the patient’s allergies?
  
• Do the doctor and pharmacist know about any other medication or supplements the patient is taking so they can minimize the possibility of a potentially dangerous interactions?
  

Sources: Journal of American Medical Informatics Association,