Medication Errors Injure More than 1 Million People per Year

By Christina Orlovsky, senior staff writer

When the Institute of Medicine (IOM) released its landmark patient safety report To Err is Human in 1999, the health care community was awakened to the sobering statistics that as many as 98,000 people die each year in hospitals due to preventable medical errors. Since then, many health care and patient safety organizations have implemented numerous practices to improve safety and reduce mortality from errors in health care facilities. However, a new IOM report released this week shows that not enough has been done, particularly when it comes to medication errors and adverse drug events.

The report, Preventing Medication Errors, points out the staggering numbers associated with preventable drug-related injuries per year: 400,000 in hospitals—averaging more than one per day—800,000 in long-term care facilities and another 530,000 among Medicare patients in outpatient clinics. In all, the report’s authors estimate that at least 1.5 million people are harmed by errors involving prescription medications each year, adding that this is likely an underestimate.

In the hospital setting alone, these adverse drug events account for at least $3.5 billion in extra medical costs, the IOM committee reported.

“The frequency of medication errors and preventable adverse drug events is cause for serious concern,” said committee co-chair Linda R. Cronenwett, Ph.D., RN, dean at professor in the school of nursing at the University of North Carolina, Chapel Hill. “We need a comprehensive approach to reducing these errors that involves not just health care organizations and federal agencies, but the industry and consumers as well.”

According to the IOM, medication errors include all mistakes involving prescription drugs, over-the-counter products, vitamins and dietary supplements. Errors run the gamut from prescription and administration mistakes to monitoring patient response.

Specific concerns raised by the IOM committee included problems with patient-provider communication, leading to a patient’s misunderstanding of a drug’s dosage and side effects, as well as a patient’s lack of awareness of what medications he or she is taking and what it is prescribed to treat.

Additionally, the committee spoke out advocating for the use of computerized prescribing systems to reduce the risk of error related to physician handwriting or misinterpretation of a dosage or drug name. The IOM recommended that all health care providers have plans in place to write prescriptions electronically and implement these plans by 2010.

Further recommendations made by the IOM include: encouraging patients to advocate for their own safety by asking questions of their providers about medications; improving patients’ capabilities for medication self-management; making patient information and decision-support tools available for consumers; improving methods for drug labeling and communicating drug information to consumers; establishing standards for drug-related health information technologies and allocating government funds for research on medication safety.

In a statement about the report, committee co-chair J. Lyle Bootman, Ph.D., Sc.D., dean and professor of the University of Arizona College of Pharmacy, called attention to the country’s dire need for protection against preventable medication errors.

“The American people expect and deserve safe and effective care,” he said.

“Our committee has developed an ambitious agenda for making the use of medications safer and ensuring that patients experience the desired clinical results,” he added. “This agenda requires that all stakeholders—patients, health care providers, payers, industry and government—commit to working together to prevent medication errors. Given that a large proportion of injurious drug events are preventable, this proposed agenda should deliver early and measurable benefits.”

For more information, visit the Institute of Medicine Web site.

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