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Here are a few cautionary tales of medication taken incorrectly:

23-Oct-2006: Lasers, computers and MRIs are all high-tech tools in health care, but prescriptions are written and filled by human beings, and mistakes can happen.

Pharmacists and doctors take steps to make sure their patients take the right pills - in the proper doses - at the right time, but drug errors happen, and one of the biggest reasons why is communication failure.

"Pharmacists are instructed to offer counseling to all patients who are getting a new prescription," says Dennis Jones, executive secretary of the South Dakota Board of Pharmacy. "But too often, patients do not feel well, and they feel they don't need that counseling."

Jones says patients can help themselves by not declining that counseling. In an age when some patients, especially older ones, have multiple doctors and multiple medications, drug interactions - and problems caused by mistakes - can spring up.

"Finding one pharmacist you trust, then keeping him or her and asking questions of them, will make a big difference," Jones says. "To avoid drug errors or problems, patients should take their prescriptions out of the package, look at it, and go over the label with their pharmacists."

Andrea Darr, a pharmacist with Avera McKennan Hospital, works mostly with admitted patients. She says that, too often, pharmacists are not asked questions that patients have, nor are doctors.

"Before you leave the doctor's office, you should ask what the drug is for and what it's called, not only the brand name but the generic name as well," she says. "Patients should also make sure they understand the dosage."

Darr says not all prescriptions are pills or capsules. With liquids, topical solutions and nebulizer, patients might not really understand how an accurate dose is measured.

"Too often, there's a knowledge gap," she says. "When some patients - especially patients in their 70s or 80s - are taking 20 or more medications, there can be cases where the pharmacist doesn't know all the drugs the person is taking and what the possible interactions can be," she says. "Even if a patient gets some drugs through mail order or from another pharmacy, the pharmacists should have a complete list of all medications taken to avoid possible problems."

When generic drugs are offered to save a patient money, they are not always 100 percent equivalents. But doctors often see a complacent attitude with patients.

"It's a two-way street," says Timothy Donelan, a family medicine doctor with Sioux Valley Clinic at Sioux Valley Hospital Wellness Center. "We encourage patients to ask questions, and, as consumers, we do so much research on things we buy, but with drugs, too often, there's assumptions."

Patients with multiple physicians might assume their doctors confer, but that's not always the case. Donelan says there are three levels of pharmacy communication. Even on a simple level, the potential for mistake is clear.

"One level is what I tell the patient to do; then there's what the pharmacists say," Donelan says. "The third level is what the patient actually does."

Carol Hively, corporate spokeswoman with Walgreen Co., says every conversation between patient and pharmacist is important.

"At the pharmacy, the patient should read the prescription label on the bottle and any printed material that comes with the medicine," she says. "That way, they will be familiar with the drug and how to take it, and to ensure it's the drug they were prescribed."

To avoid problems, Donelan goes over the instructions with the patient, then has his patient verbalize the directions back to him.

Jones says while mistakes can happen, when patients take responsibility - and ask questions, even when there's a line at their favorite pharmacy - those problems will happen less frequently.

"I'm a hospital pharmacist by trade, and, oftentimes I will ask a patient if they have an allergy, and they have to check to see if they do," he says. "In some cases, they will have an allergy to the drug. Just that simple conversation can save a possible problem."

Source: Sioux Falls Argus Leader

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