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A prescription for better medicine

By TIMES EDITORIALS
Published July 22, 2006

The illegible handwriting of physicians has long been the fodder of jokes, but it is not so funny when misread prescriptions lead to lethal medication errors. A new report finds that nationwide 1.5-million people a year are harmed by mistakes in their medications and several thousand die each year from the errors. Numbers like that should get the medical establishment's attention, particularly when some long-overdue modifications could go a long way toward prevention.

According to the Institute of Medicine report, mistakes in drug delivery are so widespread that the average hospital patient experiences one for every day spent hospitalized. Everything from drug overdoses, improper drug combinations and the simple misreading of prescriptions are among the common errors, and at least a quarter of them are preventable.

The report recommends some easy fixes and some that are more complex and expensive. One of the easy measures is for patients and their families to routinely get a list of their medications and dosage and understand what each drug is for. They should bring the list to all doctor visits and aggressively ask questions about care.

But what would lead to a significant reduction in mistakes in hospitals is electronic prescribing - a protocol that is inexcusably many years away from widespread adoption. Not only would computerized prescribing cut down on the errors associated with a doctor's handwriting and the use of nonstandard abbreviations, but when a prescription is entered into a database, an alert would flash if the dose is too high or would mix dangerously with another medication the patient takes.

The report recommends that all prescriptions be written electronically by 2010. In the meantime, doctors should heed a simple safety recommendation and block print all handwritten prescriptions to ensure legibility, using only standard abbreviations and dose designations. When verbal directions are given in a hospital setting, they should be repeated back by the responding caregiver. Now, that doesn't seem like too much to ask.

Moving the medical establishment into standardized electronic record-keeping, drug labeling and dispensing has been in the works for a long time without much to show for it. The institute's report demonstrates that the health of millions of patients has been put at risk because of the delay.

[Last modified July 22, 2006, 01:27:01]