Wednesday, August 09, 2006
The sick will swallow anything
Luanne Traud
Recent columns
- Keep your butts to yourself
- Expect the best at WBHS
- Lessons from the home front
- From imperialism to a nation of law
From the RoundTable blog
My medicine cabinet wasn't prepared for sickness. The bottle of aspirin that nursed many a sore throat, toothache, fever and hangover ran out two days into a 10-days-and-counting summer cold, and just two tablets rattled around in the Tylenol bottle.
I thought fleetingly about the chewable Tylenol Junior but dismissed that choice because: A. They were grape; B. My slightly feverish brain couldn't calculate how many I'd need based on a weight chart that maxes out before I do; and C. They were grape.
A trip to the drug store was required. My throat was so raw, that all I could think about during the drive was rabid animals with throats so sore they couldn't lap water. No wonder they go mad.
Once I found the right aisle, I fared no better. Sans contacts and with reddened, watery eyes peering out of reading glasses that are three prescriptions old I attempted to choose between one brand of aspirin and another. Buffered? Coated? What about Tylenol? Ibuprofen? Aleve? Caplets? Pills? Gels? Extra-strength, maximum-strength, strongest without a prescription? Is pain relief like Starbucks where regular size starts at grande? With 300,000 over-the-counter drugs from which to select, how do you hit on the right one?
I swept several bottles into my basket and $58 lighter headed for home to sort it out.
I am sharing this with you, dear reader, not to exact your sympathy (although cards, flowers and candy are always appreciated), but because I know you've stood in the same drug store aisle and come to the same conclusion: Sick people can't be trusted with drug decisions.
When you feel miserable, you might drink grape-flavored cyanide if someone in a white coat handed you a paper cup and told you it would make you well.
In the quest to feel better, caution and common sense move out as pain, fatigue and confusion set in. Surprisingly to me, Ms. Read Every Label, was how readily my usual overly-cautious self would have failed to heed every warning. And, OK I'll admit it, I was just a little sick.
Imagine the truly ill. The hospital patients. The nursing home patients. The chronically ill. At least they are out of the self-prescribed, over-the-counter drug aisle and into the properly prescribed realm of physician and pharmacist care.
Unfortunately their odds of taking the wrong medication or the wrong dosage are quite sickening.
More than 1.5 million Americans each year are injured -- sometimes fatally -- from prescription medication mistakes. The Institute of Medicine's recent report contained a stunning finding: On average, a hospital patient is subject to at least one medication error per day.
According to the institute, hospitals alone commit 400,000 preventable drug errors. Nursing homes account for 800,000 drug errors and another 350,000 occur at out-patient clinics serving Medicare recipients. Those are just the known errors.
Each error comes with a high price both to the patient's health and medical bill. Serious drug errors add about $5,800 additional hospital costs to each harmed patient and account for about $3.5 billion in annual health care costs.
Congress in 2003 asked the institute, a branch of the National Academies, to undertake the extensive study following an earlier report that 7,000 people die each year from medication mistakes. In addition to the more indepth study, the U.S. Food and Drug Administration adopted regulations to encourage better reporting of drug errors and the use of technology to prescribe and fill orders.
With 4 billion prescriptions filled each year, some errors are bound to occur. But 1.5 million? Studies have shown that hospitals and nursing homes can reduce errors by 73 percent if they use electronic prescribing systems.
The systems can verify if a medicine is appropriate for a patient's condition. The systems work toward eliminating errors based on poor handwriting or mixing up drugs with similar sounding names. They also monitor patients' allergies and other medications to flag dangerous interactions and raise concerns when dosage amounts appear too high.
Yet, the study found, just 6 percent of health care institutions use computer prescription systems.
That these systems exist and that so few hospitals use them in today's technology-laden health care industry is as backward as buying a pint of snake oil serum off a covered wagon.
We should advocate for systems to correct medication errors while we are feeling well. We owe it to our future ill selves. Once the backless gown goes on, we're likely to swallow anything to feel better without question.
Traud is a Roanoke Times editorial writer.
