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Pharmacists advocate multidisciplinary approach
When it comes to a stay in the hospital or a visit to any other health care facility, the prospect of medication errors worries patients the most, according to a study conducted by the American Society of Health-System Pharmacists (ASHP).
Conducted by telephone during July 1999 among some 1,000 randomly selected respondents, the survey indicated that many Americans have a relatively high level of anxiety surrounding hospital or health system visits, according to Bruce Scott, MS, RPH, president of Washington, DC-based ASHP. The majority of respondents said they were "very concerned" about a number of issues, including:
- being given the wrong medication (61%);
- being given two or more medications that interact in a negative way (58%);
- the cost of treatment (58%);
- complications from medical procedures (56%);
- getting an infection (50%);
- suffering from pain (49%).
"Pharmacists have recognized this problem for a long time, but it has only recently come to the forefront and become recognized as the major safety problem it presents. As more sophisticated and powerful drugs enter the market today, patients are increasingly worried about the accuracy, safety, and appropriate monitoring of their medications to ensure the best outcomes." Scott adds that the study shows that "patients need to feel more comfortable about their pharmaceutical treatments. (See box on key findings, p. 10.)
A little more than three out of four survey respondents (76%) said that speaking with a pharmacist while in a hospital or health system would help allay their medication concerns. Sixty-five percent, meanwhile, said that speaking with a pharmacist in person would be the preferred method of receiving information about their medications.
But at the same time, people appear to be unaware of the role of pharmacists and the milieus they operate within.
For example, another ASHP survey released in 1998 revealed that patients often don’t realize that pharmacists are integral members of the patient-care team. When asked to name health care providers who work in hospitals, only 1% of those surveyed mentioned pharmacists, and only 12% of respondents said that while in a hospital, they had met with a pharmacist. However, 87% of respondents said that they would want to talk with the on-site pharmacist if they ever were a patient in a hospital or health system.
"In light of these statistics, ASHP wants patients to know that pharmacists are a great resource for medication information and are available to speak directly with patients and their families about the medications they receive while in the hospital or health system," says Scott. "These new data should also be helpful to hospitals and health systems across the country so that health care professionals can help lower the level of patient anxiety regarding medication use."
With the problem of medication errors now recognized as an important component of the population’s perception of the health care system, there is also the realization in the medical community that no one single profession alone can solve it, he says.
Within many health care organizations, "multidisciplinary teams comprised of physicians, pharmacists, and nurses are now working to-gether to address this problem," according to Scott. This type of approach is long past due, he notes, "and I think it provides much higher chance of success for the needed improvement of systems out there."
Scott says he is also excited about technological advances that promise to help in the battle against medication errors. "There are a number of technologies that have not made their way into health care yet that I am confident are going to help us have more fail-safe systems."
These systems, some of which are based on technology that includes bar-code reading, typically help address the medication-error problem through doing away with the need for handwritten prescriptions.
"It is absurd that today physicians still hand write prescriptions," says Scott, "in an age when we have bar-code readers and point-and-click’ software that don’t rely on people having to decipher handwriting."
These systems are not currently widely implemented, says Scott. "But they are coming — and that alone is encouraging."
In the meantime, he advises health care organizations that want to get a handle on the problem of medication errors to "take the multidisciplinary approach, and collect all the data regarding errors — including the number and type of medication mistakes, missing/wrong doses, etc. — that you can."
This comprehensive data-gathering approach helps a health care organization understand what part of the system is breaking down and causing errors, says Scott, "and is essential to targeting and focusing resources and interventions."