All prescribers and pharmacies should be using e-prescriptions by 2010, US experts on drug error prevention have recommended.
A report from the Institute of Medicine’s committee on identifying and preventing medication errors says that greater use of information technology in prescribing and dispensing medicines is one of the main steps that should be taken to reduce errors.
The committee analysed various studies on medication errors and concluded that there were at least 1.5m preventable "adverse drug events" (ADEs) in the US every year – and that the true figure may be much higher.
In the section on using IT more extensively, the report says: “Doctors, nurse practitioners and physician assistants, for example, cannot possibly keep up with all the relevant information available on all medications they might prescribe – but with today’s information technologies they don’t have to.”
It recommends e-prescribing should be adopted universally in the US over the next four years using systems that follow the patient from the hospital to their doctor’s surgery or from the nursing home to the pharmacy, avoiding many of the hand-off [handover] errors common currently.
It adds: “More generally healthcare suppliers should seek to be come high-reliability organisations pre-occupied with improving medication safety. To do this they will have to take advantage of the latest information technologies and the most up to date organisational and management strategies.
“They will also need to put effective internal monitoring programs in place, which will allow them to determine the incidence rates of ADEs more accurately and thus provide a way of measuring their progress towards improved patient safety.”
The other main proposal for reducing medication is what the committee terms a “paradigm shift in the patient-provider relationship.”
The report explains: “The first step is to allow and encourage patients to take a more active role in their own medical care. In the past the nation’s healthcare system has generally been paternalistic and provider-centric and patients have not been expected to be involved in the process.
“One of the most effective ways to reduce medication errors is to move towards a model of healthcare where there is more of a partnership between the patients and the healthcare providers. Patients should understand more about their medications and take more responsibility for monitoring those medications, while providers should take steps to educate, consult with and listen to the patients.”
Technology can play a part in this change too, the report finds, with opportunities to make more and better drug information available over the internet.
Finally the report suggests the drug industry and federal agencies should look at drug nomenclature to avoid errors that occur when two different drugs have names that look or sound very similar
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