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