I just got off the phone with a very upset patient who had just discovered that her pharmacy had been giving her the wrong medication for the past 5 months, substituting a similarly spelled antibiotic for her rheumatoid arthritis med. She was tipped off when she realized how bad she had been feeling of late and decided to check the expiration date of her med, only to find it was the wrong drug. I won’t get into the unethical behavior of the pharmacist when she pointed out the error, something I’ll be reporting on her behalf to both the head of the pharmacy chain and the state pharmacy board.
But that’s not the point of this post. The point is that, despite all our fancy technology and advances in health care, medication errors can and will occur.
So what can you do, as a patient, to be sure that your prescriptions are correct?
1. Keep a list of your current meds with you at all times. Include brand or generic name, dose and frequency. Paper, online, or on your phone — wherever its easiest and most accessible. But a paper list in your wallet will cover you in emergencies, so consider that even if you use your phone routinely.
2. Cross check and update your med list with your provider at every visit. In quality parlance we call it medication reconciliation, and it’s one of the most important things we docs do at a patient visit. You’d be shocked how many patient come to a visit without knowing the names of the drugs they are taking. Now, if I go to prescribe a new medication, how can I be sure it doesn’t interact badly with something you are already taking? Or even if you may already be taking the very med I am prescribing? If I’m lucky, your pharmacist will pick it up, but only if you’ve filled a prescription in his system before. Don’t leave it to chance. Take charge.
3. Ask for an updated list of your medications and prescriptions before leaving your doctor’s office. Most EMRs can create a current med list, so ask your doc or his/her staff for a copy. If you use it as your med list to carry with you, we’ll all be on the same page. Alternatively, if your practice gives out an after visit summary (AVS) at check out, that usually will have your med list on it.
4. If you’re tech savvy, use the practice portal. Your providers practice portal has a med list. Take it upon yourself to check the portal between visits to be sure your med list is up to date and correct. You can usually print your med list yourself from the patient portal.
5. Cross check every med after you pick it up against the prescription your provider wrote. This includes refills. Use your printed med list, the portal or your AVS to check what your provider wants you to be taking. If you don’t have that, you can ask the pharmacist for a copy of your prescription. Don’t wait till side effects occur, as my patient did, to double check. Your health is too important for that.
6. Don’t hesitate to speak up if you think a prescription is wrong. You take it once a week, and now it says twice a week? Say something. And it’s not just the pharmacist who can make a mistake. Your doc isn’t perfect either. In fact, we’re less perfect in some ways since we started using the EMR to write prescriptions. More than once, I’ve caught myself typing in a prescription in the wrong patient’s chart — with up to 4 charts open on the computer screen at a time, it happens, trust me. Recently, my EMR made every part of a prescription a discrete field or check off box from a drop down, so that writing a single prescription is more like completing an online tax return than ordering a med. I hate it. It used to be so much faster (and safer) for me to just write or type out the frequency and dose. So please, stop me if you think I got it wrong.
7. Finally, don’t forget that so called “natural” supplements are meds too. Don’t get me started on the over use of these unregulated products. (And yes, overuse of prescription drugs as well, but at least we know whose making them and what’s in them.) But do know that many, many interactions can occur between so called “natural” products and prescription meds. So if you’re taking any kind of supplement, vitamin, herb or natural product, be sure to add it to your med list.
Margaret Polaneczky is an obstetrician-gynecologist who blogs at The Blog That Ate Manhattan.
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