Take Control of Your Medicines – Keeping You and Your Family Safe

By Michael J. Negrete, PharmD
CEO, Pharmacy Foundation of California

We are becoming increasingly bombarded in the media by stories about celebrities who are being taken from us far too soon because of the improper use of perfectly good medications. Unfortunately, these stories do not even begin to scratch the surface of a rapidly escalating public health crisis in our country.

According to an article that was published last year in the Archives of Internal Medicine, an astonishing number of Americans are dying in theirhomes because of mistakes in the way their medications are being used. By the end of 2004 (the last year CDC death certificate data was available for the study), almost 12,500 Americans per year were being killed in this manner.  On average, that’s more than 34 Americans each day.

What is even more concerning is the rate at which these deaths are increasing. During the 21 year study period, the rate at which people were dying in their homes from preventable medication mistakes increased by 775 percent. A significant contributing factor to this growth was fatalities related to the use of medications with alcohol and/or street drugs. The death rate for this type of fatality increased by almost 3,200 percent over that timeframe. This figure and recent celebrity deaths may tempt us to categorize the problem as one associated only with “recreational drug use,” but in reality, more than two out of every three unintentional medication-related deaths occurring in people’s homes have nothing to do with alcohol or street drugs.

The factors contributing to this rise are many and show no signs of slowing. They include the aging of our population, the increasing incidence of chronic disease, and the growing expectation that patients and caregivers manage their illnesses at home, largely on their own.

This, combined with fragmentation of healthcare delivery, inadequate information technology, and financial and workload pressures put on our healthcare providers, will only increase the frequency at which we give Americans medication without also providing them the information, tools and support they need to safely use it.

Most Americans trust their doctors, pharmacists and other healthcare providers to ensure their medications won’t cause serious harm, or even death. What they need to understand however, is that no matter how intelligent or well intentioned their doctor and pharmacist may be, they too often are not given all information and time they need to ensure the safety of their patients’ medication therapies.

It is far too easy for a medication to be prescribed and dispensed which conflicts with another prescription, non-prescription, or herbal medication a patient is taking. It is far too easy for a patient to be given a medication to treat a problem that is actually the side effect of another medication that the prescriber does not know about. It is far too easy for a patient to miss that “routine” lab test which would have provided an early warning that the new medication being taken is destroying their liver.

The good news is that much of the injury and death which occurs in our homes from the unsafe use of medications is completely preventable. To keep our cures from becoming killers however, patients and caregivers must undergo a paradigm shift. 

It is no longer enough to assume that your doctor and pharmacist have all the information and time they need to safely prescribe, dispense, educate you about, and monitor your medications. Just as patients and caregivers are given the majority of the responsibility for how medications are used and monitored at home, patients also have to assume the responsibility for ensuring that their doctor and pharmacist make the time to perform the tasks that will help ensure the safe use of medications. 

Tasks like gathering and reviewing all the information about medications and health conditions, and screening for potential conflicts between and among medications and diseases; education about when and how to take medications, what to expect in the way of positive and negative effects and when to expect them; and providing tools such as specialized packaging and home monitoring devices that will help patients take their medication correctly and know whether it’s working.

It’s unfortunate that our healthcare system must place so much responsibility on patients and caregivers.  At the very least, it should be expected to also give them the tools, information and support they need to succeed.