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Medication errors harm 1.5 million, New IOM
study says
Senator Moore Contributed to report |
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BOSTON – Medication errors harm 1.5 million people and kill several thousand each year in the United States, costing the nation at least $3.5 billion annually, according to an 18th month study by the Institute of Medicine. According to one estimate, in any given week four out of every five U.S. adults will use prescription medicines, over-the-counter (OTC) drugs, or dietary supplements of some sort, and nearly one-third of adults will take five or more different medications. Most of the time these medications are beneficial, or at least they cause no harm, but on occasion they do injure the person taking them. Some of these “adverse drug events [ADEs],” as injuries due to medication are generally called, are inevitable--the more powerful a drug is, the more likely it is to have harmful side effects, for instance--but sometimes the harm is caused by an error in prescribing or taking the medication, and these damages are not inevitable. These errors can be prevented. At the urging of the Senate Finance Committee, the United States Congress mandated that Centers for Medicare and Medicaid Services sponsor a study by the National Academy’s Institute of Medicine (IOM) to address the problem of medication errors. Among those credited with contributing key information was Massachusetts State Senator Richard T. Moore, Senate Chair of the Legislature’s Committee on Health Care Financing. In April 2005, Senator Moore was invited by the Institute of Medicine to make a presentation on medication safety to the committee that was developing the medication safety study. He reported on the advances in Massachusetts and other states that were led by legislators promoting patient safety. The report, “Preventing Medication Errors,” cited the death of Betsy Lehman, a 39-year-old mother of two and a health reporter for The Boston Globe, as a classic fatal drug mix-up. Ms. Lehman died in 1993 after a doctor mistakenly gave her four times the appropriate dose of a toxic drug to treat her breast cancer. Senator Moore was the primary sponsor of state legislation establishing a state patient safety center that was named in Ms. Lehman’s memory. Preventing Medication Errors puts forward a national agenda for reducing medication errors based on estimates of the incidence and cost of such errors and evidence on the efficacy of various prevention strategies. The report finds that medication errors are surprisingly common and costly to the nation, and it outlines a comprehensive approach to decreasing the prevalence of these errors. This approach will require changes from doctors, nurses, pharmacists, and others in the health care industry, from the Food and Drug Administration (FDA) and other government agencies, from hospitals and other health-care organizations, and from patients. Recommendations to correct these problems include systemic changes like electronic prescribing and tips for consumers like advising patients to carry complete listings of their prescriptions to every doctor’s visit, the report said. Massachusetts, under Senator Moore’s leadership, has been in the forefront of electronic prescribing for the past five years. The recently passed health care reform bill included another $5 million for electronic prescribing and electronic medical records. The report is the fourth in a series done by the institute, the nation’s most prestigious medical advisory organization, that has called attention to the enormous health and financial burdens brought about by medical errors. Drug computer-entry systems, which are supposed to ensure that hospital patients get the right drugs at the right dose, are used in just 6 percent of the nation’s hospitals, according to the IOM study. Electronic medical records can help ensure that patients do not receive toxic drug combinations. The 1999 report urged widespread adoption of these systems. Thursday’s report called for all prescriptions to be written electronically by 2010. Just 3 percent of hospitals have electronic patient records, said Henri Manasse, chief executive of the American Society of Health-System Pharmacists. Few doctors prescribe drugs electronically. Even simple medication safety recommendations — block printing on hand-written prescription forms — are widely ignored. The IOM report said that the common practice whereby drug companies provided free drug samples to doctors should be discouraged because such samples were poorly controlled. It urged drug makers to package more pills in individual packages. And it criticized drug makers as failing to disclose the results of all clinical trials involving their drugs. Senator Moore has been a strong advocate of curtailing the influence of pharmaceutical marketing efforts on physicians. |
