At least 1.5 million Americans are injured or killed every year by medication errors at a direct cost of billions of dollars, according to a report issued Thursday by the prestigious Institute of Medicine.
Mistakes in giving drugs are so prevalent in hospitals that, on average, a patient will be subjected to a medication error each day he or she fills a hospital bed, the report says.
The report is a follow-up to a 1999 report from the institute, which is part of the National Academy of Sciences, that outlined all medical errors and claimed that as many as 7,000 people are killed each year as a result of medication errors.
“We were initially quite surprised by the number of mistakes, but the more we heard, the more convinced we were that these are actually serious underestimates,” said panel member Dr. Kevin Johnson of Vanderbilt University.
Each year, there are an estimated 400,000 preventable drug-related injuries in hospitals, costing at least $3.5 billion, the report says. There are also 800,000 medication-related injuries in nursing homes and other long-term care facilities and about 530,000 among Medicare recipients in outpatient clinics. The report provided no estimate on the cost of the errors in those facilities.
“We’ve made significant improvements since 1999 … but we still have a long way to go,” said J. Lyle Bootman of the University of Arizona College of Pharmacy, co-chairman of the panel. “The current process by which medications are prescribed, dispensed, administered and monitored is characterized by many serious problems that threaten both the safety and positive outcomes of patients.”
The panel cited a variety of causes for the problems.
One is unexpected drug interactions. With more than 15,000 prescription drugs in use and 300,000 over-the-counter products, “it is virtually impossible for a human to track all the interactions any more,” said Dr. Wilson W. Pace of the University of Colorado.
Another is the similarity between drug names, which often results in the wrong drug being given. For example, Fosamax, the osteoporosis drug, could be mistaken for Flomax, given to improve urination in patients with an enlarged prostate.
Other problems include the legendary bad handwriting of physicians, nurses giving patients drugs meant for another patient, pharmacists dispensing the wrong drugs and patients not understanding how to take the drugs.
In Washington state, lawmakers have already addressed the issue of legibility. A law that took effect June 7 bans cursive, requiring prescriptions to be hand-printed, typed or electronically generated.
For many of these problems, an electronic prescribing and data system is the best hope, the report said. The panel recommended that all health care providers have plans in place by 2008 to move to electronic prescribing, and that doctors give up their traditional prescription pads by 2010.
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