drug prescriptions

  1. Question authority -- question your doctor

    For years, the doctor-patient relationship went a little something like this: Patient visits the doctor... doctor tells the patient what to do.

    That's the way it still is in many practices, and that might even describe your relationship with your own doctor. But you're perfectly capable of making decisions about your health -- and two new campaigns are urging you to do just that.

    And it starts with three simple questions:

    1) What are my options?

    2) What are the possible benefits and risks of those options?

    3) How likely are the benefits and risks of each option to occur?

    Those three questions, part of a new campaign from Britain's Cardiff & Vale University Health Board, can dramatically change your understanding of both your diagnosis and the possible treatments -- and could lead you to rethink everything from your drug prescriptions to surgical recommendations.

    But I'd add one more to the list -- one that's even more important, even if you won't get a straight answer to it from some doctors:

    4) What are my alternatives?

    Believe it or not, that very question is actually one our own government is encouraging you to ask -- although, let's face it, they're almost certainly referring to choosing one med over another rather than a natural supplement over a dangerous drug.

    In any case, it's a crucial question that you should ask any time you're handed a treatment plan -- and the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services, is urging more patients to ask it as part of its "Questions are the Answer" campaign.

    Hard to believe I'm saying this about a government health program, but they're actually on the right track here.

    The agency even recommends three crucial questions for anyone facing surgery -- questions too many people never bother to ask:

    • Why do I need surgery?
    • Are there other ways to treat my condition?
    • How often do you perform this surgery?

    The best part of this campaign is the website, which features a "Question Builder" to help you create a customized list you can print out and bring to your doctor.

    Doctors might not be used to getting all these questions from their patients -- but a good doctor won't be afraid to answer them.

  2. Human error goes digital

    Looks like computers are only human after all.

    Computers were supposed to change healthcare permanently and forever, and in many ways they have.

    But when it comes to slashing the number of medical mistakes, we still have a long way to go -- because it turns out computers are just as likely as humans to botch drug prescriptions.

    Researchers looked at data on 3,850 electronic prescriptions filled at pharmacy chain locations in three states during a four-week period in 2008.

    The researchers say they found mistakes in 11.7 percent of all prescriptions and that four percent were serious enough
    that they could have led to adverse events, according to the study in the Journal of the American Medical Informatics Association.

    That's right in line with the error rate we've (sadly) come to expect from the traditional handwritten prescriptions --which proves that many of the problems don't stem from a doctor's poor handwriting.

    They stem from a poor attention to detail.

    Most of the mistakes were omissions: The researchers say more than 60 percent of the errors involved missing details
    such as dose, frequency, and number of days.

    Now, if you're like me, you're probably wondering why the software allows e-prescriptions to be sent to the pharmacy
    with all those missing blanks.

    Short answer: It doesn't.

    Just about all the programs used for electronic prescriptions have a setting that rejects the prescription if it contains missing data, forcing the doctor to fill it all in before it can be sent.

    But docs aren't using it -- that setting is either being shut off, or it was never turned on in the first place.

    These programs also have a setting that figures out possible drug interactions as well as the maximum dose of each med -- and again, docs aren't using it.

    The researchers say simply switching on those two functions alone would have prevented 77 percent of the errors uncovered by their study.

    I think it's time someone rewrites the software so those functions can't be turned off.

    In the meantime, whether your prescription comes from a pen or a machine, the same rules apply: Ask your doctor what you're taking, how much you should take and when you should stop.

    Write it down if you have to.

    And then make sure the drug label that ends up in your hands matches what you were told in the exam room.

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