IOM estimates at least 1.5 million adverse drug events preventable
A report released this month by the National Academy of Sciences Institute of Medicine entitled "Preventing Medical Errors" found that while some of the adverse drug events that occur each year in the United States are inevitable due to the powerful nature of many drugs and their side effects, at least one quarter, or 1.5 million of these "ADE"s are due to errors in prescribing, dispensing, administering, or monitoring medications. Even without taking into account errors of omission in prescribing drugs, the authors of the study note that the true number of preventable errors is probably much higher than the 1.5 million figure.
The authors of the IOM report examined a number of recent studies to draw their conclusions, focusing mainly on reports published between 1995 and 2005. They state that on average, a hospital patient is subject to at least one medication error per day (although rates vary across facilities), which increases the cost of hospitalization significantly. One study of Medicare patients estimated a cost of $887 million dollars resulting from the treatment of medication errors each year, which did not include lost earnings or pain and suffering rewards.
To combat this situation, the report recommends a greater partnership between patients and health care providers. Patients need to assume more responsibility by monitoring the effects of their medications, keeping records, and communicating with their physicians. In turn, the health care system needs to provide more and better information to patients concerning the medications they are taking, and offer more opportunities for patients to consult with their providers. Additionally, electronic prescription systems should be implemented which will eliminate errors that arise from hand-written prescriptions. These systems also provide information on the drugs being prescribed and can interface with patient history to determine the presence of allergies, or other drugs in use by the patient, and this information can be transferred along with the patient to other facilities.
Labeling and packaging of medications by the manufacturer is another area that can be improved to help eliminate medication errors.
The authors of the report conclude that "the current state of affairs is not acceptable." They recommend federally funded studies on the prevention of medication errors, and that more training in medication management be required by accreditation agencies.
Needless to say, a reduction in the prescription of dangerous, needless, or ineffective drugs and a greater emphasis on preventive medicine would go a long way as well toward reducing adverse drug events, preventable or otherwise.
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