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A new study of prescription medication errors at primary care doctors’ offices found that written and verbal communication problems were the most common causes of the errors, followed by knowledge deficits by doctors, pharmacists and patients.
Over a 10-week period, researchers at the Cleveland Clinic collected data related to 507 prescription medication events involving patients of all ages. 70 percent of the events involved medication errors without adverse events, 27 percent involved adverse medication outcomes without errors, and 2.4 percent involved both.
At least 11 percent of the errors involved physical or emotional harm to a patient. Of those patients known to have been harmed, eight required hospitalization and three sustained a permanent injury. The causes of the hospitalization were medication errors (3 cases), adverse drug events (4 cases), or both (1 case).
The most common type of prescription involved was cardiovascular medication. In 18 percent of the cases, the errors involved two or more prescriptions. The number of errors varied widely among the practices studied, but the average number of medication errors reported was 14 per week.
Transcription Errors, Verbal Communication Problems, Lack of Knowledge Most Common Issues
In 41 percent of the cases, the cause was a written or verbal communication problem. 22 percent of the time, lack of knowledge by the doctor, pharmacist or patient was the cause of the error.
Generally, the issues involving lack of knowledge included those where a doctor prescribed an unavailable dosage or form of the medication, or where the patient or pharmacist didn’t have information about currently prescribed medications or doses. In one case, a patient who could not read took four times the correct dose.
The report found that the source of the prescription error was equally divided among four areas: errors by the prescribing physician, errors in implementation of the prescription order, patient errors, and documentation errors, meaning that the medical record or list of home medications was not up to date.
The types of errors reported, broken down by percentage of occurrences, included:
Prescriber errors: 28 percent
Pharmacy errors: 24 percent
Patient errors: 20 percent
Failure to monitor: 4 percent
Documentation errors: 24 percent
A medication error can have devastating or even deadly consequences. The best thing patients and their families can do is to focus on good communication at every step:
When your health and safety are on the line, there are no stupid questions.
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