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Health Care

Pharmacy patient safety

How to improve medication quality and reduce errors and costs

ne of the basic assumptions about health

care is that patients take medications
to aid care. However, there may be
times when medication does not aid care, but
rather, jeopardizes patient safety. Therefore,
medication safety is an issue that should be
taken seriously by health care professionals
and patients alike.
According to the Institute of Medicine
an independent, nonprofit organization at
least 1.5 million Americans are sickened,
injured, or killed each year by medication errors. The cost related to preventable errors
has been conservatively estimated at $3.5 billion a year and does not include lost wages,
decreased productivity and additional health
care costs.
Many medication errors are largely preventable, says Chronis Manolis, vice president, Pharmacy, for UPMC Health Plan. By
improving patient education and putting the
right programs in place, these errors can be
reduced.
Smart Business spoke with Manolis about
patient safety in terms of medication and what
can be done to improve medication quality
and reduce errors and costs.
What are some examples of medication errors?
There are three general categories of medication errors: those related to prescribing a
medication, those related to the dispensing of
a medication at a pharmacy and those related
to the use of a medication. For each category,
steps can be taken by providers and patients
to limit the occurrence of errors.
In terms of prescribing, a physician needs
to have complete medical information about
the patient when determining appropriate
medications to not only treat a particular condition but to ensure that it will not be harmful. This information includes all medications
the patient is taking, all laboratory test results,
other physicians involved in the patients treatment, any past hospitalizations and any drug
allergies the patient may have. It is critical that
patients have their complete personal medical
history and treatment information and make
sure that this information is passed on to their
physician.
Dispensing errors occur when patients receive a medication that was not intended to
be given by the prescriber. Several factors
contribute to this error, such as hard-to-read
prescriptions, medications that have similar
names or appearances, patients who have the
same name as another patient and any communication barriers that may exist.

effects they may cause, how long they need

to be taken and whether the medicine can be
taken in conjunction with other medicines or
supplements, such as herbs.
What are some additional tips?

Chronis Manolis, RPh

Vice president, Pharmacy
UPMC Health Plan

Lastly, patients may use a medication incorrectly or in error. Often, they do not understand which medications are to be taken,
when to take them, what condition the medication is for, the importance of each medication, which medications interact with each
other, or how to properly use the medications.
Because patients are central to many medication errors, significant effort is needed to
improve knowledge, skills and motivation to
use medications correctly.
How can patients become more educated about
medication safety?
The path to better medication safety begins
with increased knowledge. Understanding the
specific condition and how it is being treated
is an important first step.
Patients can begin by keeping a list of all the
medications they take, including prescription
medicines and over-the-counter medicines,
vitamins, and herbs, and share this information with their physician. They should always
communicate to their doctor any allergies or
adverse reactions they have ever had to medications or other substances.
It is very important that patients understand
everything about their medications. This includes why they are taking them, what side

Patients should discuss with their doctor all

aspects of the condition that the medication
is being used to treat. Also, patients should
be able to read what their physician writes
if they are given a prescription. Having ones
physician send the prescription electronically
(if available) to the pharmacy can avoid handwriting challenges and drug name similarities,
which will, in turn, improve safety.
Patients should never be afraid to ask questions if there are any doubts or concerns. They
need to fully understand their role in their
care. Most important, patients must know exactly which medications need to be taken and
when, and how often they need to take them.
When a prescription is picked up at the pharmacy, they should ask if the medication being
given is the medication the doctor prescribed
and what exactly is the medication for.
What steps can be taken at the pharmacy?
Before leaving the pharmacy, always review
medication and ask to speak to the pharmacist if there are questions or confusion. For example, if the prescription looks different, ask
whether something has changed.
Patients should ask the pharmacist about
any dietary restrictions, and whether there are
restrictions with alcohol, or with other medications or over-the-counter supplements or
herbs being taken. They should ask whether
any drowsiness or dizziness can occur. Patients should request written information
about the side effects and other warnings of
the medicine. Written information has been
shown to help individuals better recognize
problem side effects. Lastly, using the same
pharmacy whenever possible for all medications is another safety tip because the pharmacist will become familiar with the patients
conditions and medication history.
Patients play a critical role in ensuring medication safety. Being actively involved in your
own care enables the sharing of key information among all providers and thus promotes
enhanced medication safety. <<

CHRONIS MANOLIS, RPh, is vice president, Pharmacy, for UPMC Health Plan. Reach him at 412-454-7642 or manolisch@upmc.edu.

Insights Health Care is brought to you by UPMC Health Plan

2012 Smart Business Network Inc. Reprinted from the June 2012 issue of Smart Business Pittsburgh.