Rx errors: the handwriting's on
the wall but is it legible?
"What did the physician say to
the pharmacist?" sounds like the start of a typical
bad joke not funny but essentially harmless.
Yet responses from pharmacists like "If you find out,
I'd love to know but don't ask them to write
it down" and docs on the defensive who come back with
"Is this another crack at our handwriting?" tend to
betray the tension between these two health professions.
It may all seem like harmless banter
until you consider that the communication breakdown
puts patients' lives in jeopardy (see "Hospital
charts riddled with errors"). Prescribing errors
plague Canadian hospitals and private practices alike
and bad handwriting is only part of the problem. Mistakes
are just as likely to occur on the pharmacists' end
even with a perfectly legible script not surprising
as pharmacists are often pressured to process prescriptions
quickly to cut down on customer waiting times.
The bottom line is that communication
is a two-way street, not just between pharmacists and
physicians but between health professionals and patients
too. If patients drop the ball in the drug compliance
department and don't inform you, changing a dosage or
replacing a medication then becomes little more than
a guessing game.
The solution, say experts, is getting
electronic prescribing systems implemented in every
province across Canada. While I'll admit that this fix
would go a long way toward protecting patients, it won't
erase the need for better communication between pharmacists,
physicians and patients. Why not? Because computerized
systems are not foolproof. Take the spell check function
in Word for example. It was meant to wipe out bad spelling
yet all wee have to show four it is a nation of spell
cheque addicts who don't no the difference between 'sore'
and 'soar.' And guess what neither does the program.
The problem is that electronic
databases are limited by how much info we give them
to begin with. So they may fail to take into account
important factors that affect prescribing. They aren't
equipped to figure out if patients are following their
drug regime or even if they're taking their medication
at all. More patient involvement in drug history taking
is key but this can only happen with more patient education.
Not only do physicians and pharmacists need to get on
the same page but they must make a conscious effort
to include patients in the prescribing loop.
Shereen Joseph, Editor
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