Medication errors injure more than 1.5m
Many mistakes preventable, study concludes
WASHINGTON -- Medication mistakes injure well over 1.5 million Americans every year, a toll too often unrecognized and unfought, says a sobering call to action.
At least a quarter of the errors are preventable, the Institute of Medicine said yesterday in urging major steps by the government, healthcare providers, and patients.
The Institute of Medicine is an independent organization chartered by Congress to advise the government on health matters.
Topping the list: All prescriptions should be written electronically by 2010, a move one specialist called as crucial to safe care as X-ray machines.
Perhaps the report's most stunning finding was that, on average, a hospitalized patient is subject to at least one medication error per day. A serious drug error can add more than $5,800 to the hospital bill of a single patient.
Assuming that hospitals commit 400,000 preventable drug errors each year, that is $3.5 billion -- not counting lost productivity and other costs -- from hospitals alone, the report concluded.
Worse, there is too little incentive for healthcare providers to invest in technology that could prevent some errors, said Dr. J. Lyle Bootman, the University of Arizona's pharmacy dean, who cochaired the institute's investigation.
``We're paid whether these errors occur or not," said Bootman.
The new inquiry couldn't say how many of the injuries are serious or how many victims die. A 1999 estimate put deaths, conservatively, at 7,000 a year.
Even the total injury estimate is conservative, Bootman said. It includes drug errors in hospitals, nursing homes, and among Medicare outpatients, but it doesn't attempt to count mix-ups in most doctors' offices or by patients themselves.
There have been efforts to improve patient safety in the six years since the institute first spotlighted medical mistakes of all kinds, including recent bar-coding of drugs to minimize mix-ups in hospitals and pharmacies.
But clearly more changes are needed, and the new report highlights how the nation's fragmented healthcare system is conducive to drug errors, said Dr. Donald Berwick, a Harvard professor who heads the nonprofit Institute for Healthcare Improvement.
The sheer volume of medications and their complexity illustrate the difficulty. There are more than 10,000 prescription drugs on the market and 300,000 over-the-counter products. It is impossible to memorize their different usage and dosage instructions, which may vary according to the patient's age, weight, and other risk factors, such as bad kidneys.
Also, 4 of every 5 US adults take at least one medication or dietary supplement every day; almost a third take at least five. The more you use, the greater your risk of bad interactions, especially if multiple doctors prescribe different drugs without knowing what you already take. Add to that doctors' notoriously bad handwriting and sound-alike drug names.
Moreover, consumer instructions are woefully inadequate, the report concludes. One study found that parents gave their children the wrong dose of over-the-counter fever medicines 47 percent of the time.
Among the report's recommendations:
