MMS Physician Focus: May 2009
By Mario Motta, M.D.
Prescription medicines are great aids in healthcare. They allow
us to manage conditions like asthma, high cholesterol, diabetes and
depression. In some cases, we can even cure or prevent
illnesses.
The Centers for Disease Control estimates that almost half of
all Americans - some 47 percent - take at least one prescription
medication and that 20 percent have three or more drugs prescribed.
The numbers get bigger with age: 60 percent of those 65 and older
have three or more drugs prescribed.
Given the extraordinarily wide use of these drugs, we should
remember that prescription medicines are powerful therapies that
must be used and guarded with care. Three areas deserve consistent
attention.
Medication Errors According to the Institute of
Medicine, medication errors injure 1.5 million people annually in
the U.S. and cost $3.5 billion to treat in hospital costs alone.
Several factors cause these mistakes: confusion among drug names;
miscommunication among doctor, patient or pharmacist about dosage
or frequency; pharmacy error in filling prescriptions; or
incomplete patient information leading to interactions with other
drugs.
The critical issue is that the Institute considers these
preventable errors. Physicians can play a key role here, by
adopting electronic prescribing programs, which can avoid many
errors and catch potential drug interactions. Patients and
pharmacists also play critical roles in medication safety, and all
parties should work together to prevent errors. Here's a basic
checklist to use for every prescription:
Tell or remind the prescriber and pharmacist about other
medications you're taking.
Ask about potential side effects.
Ensure that the prescription the pharmacy fills is what the
physician prescribed.
Understand clearly the dosages and frequency for the drug, and
unless otherwise instructed, take all of the medication
prescribed.
See that elderly patients, whose eyesight, memory, or
attention to detail may be failing, get assistance.
The Massachusetts Coalition for the Prevention of Medical Errors
offers an excellent consumer guide to medication safety, in English
and Spanish, with specifics on what to do at the doctor's office,
hospital, pharmacy, and at home. Visit www.macoalition.org to
download a free copy.
Medication Disposal An investigation in March
by the Associated Press news organization found that millions of
pounds of unused pharmaceuticals are being flushed down the drains
of America each year, mostly by health care facilities. Concern is
rising because this practice is contaminating water supplies,
though no evidence yet exists that these trace elements are causing
harm. Many of the facilities are now re-examining their practices
and instituting new and safer methods of disposal.
What should individuals do to dispose of prescription drugs
safely? Here's what the Food and Drug Administration
recommends:
Follow disposal instructions on the label. Do not flush down
the toilet unless it specifically says it's okay to do that.
If no instructions exist, take the medication out of the
original container, and mix with an undesirable substance like
coffee grounds or kitty litter.
Put the medication in a sealed container to prevent leaking or
getting loose and put into household trash.
Check for 'take back' programs in your community.
Do not give medications to anyone else.
Remove all identifying information from containers to protect
your identity and prevent theft of medical or personal
information.
Follow these steps for over-the-counter medications as well. For
more information, visit www.fda.gov/consumer/ and
search for the document "How to dispose of unused medicines."
Medication Abuse The abuse of prescription
medications by teens and young adults has become a serious problem.
They have easy access to them at home and think they're a safe way
to "get high" because the drugs have a legitimate use and are
prescribed by a healthcare provider. This kind of thinking leads to
nothing more than a self-inflicted health hazard.
The Partnership for a Drug-Free America estimates that 2,500
teenagers, every day, use a prescription drug to get high
for the first time; some are as young as 12. Pain relievers,
stimulants, sedatives, and tranquilizers are the most commonly
abused items. Parents and guardians must be especially alert if
prescription drugs are in the home. The Partnership offers a wealth
of information at www.drugfree.org/notinmyhouse
on how to combat this problem, including video presentations by
physicians and addiction specialists.
Mario E. Motta, M.D., a cardiologist with North Shore
Cardiovascular Associates in Salem, is President of the
Massachusetts Medical Society. Physician Focus is provided as a
public service by the Massachusetts Medical Society. Readers should
use their own judgment when seeking medical care and consult with
their physician for treatment. Comments toPhysicianFocus@mms.org
.
