August 10, 2014

You Can Reduce Prescription Errors

It is often the case that you go for a prescription refill and when you get home and take the container of pills out, you notice they are a different colored pill or even now a capsule instead of a pill. What to do? First, call the pharmacy and explain what you have seen. Most pharmacists will tell you they have changed suppliers or the doctor had changed your prescription. These should be red flags and you need to be careful now. You should have been told this when you picked up the prescription. If the doctor did change the prescription, you should have been notified about the reason for the change. Some doctors are increasing the dosage of statins without notifying their patients.

Hopefully, you did not wait until you were out to refill your prescription. First, check the information on the containers to be sure that it is the same medicine and the same dosage. Next, if the dosage has changed, contact the doctor to find out why and be prepared to encourage the doctor to return it to the former dosage. Document everything and if your doctor did change without informing you, be prepared.

So what can you do, as a patient, to be sure that your prescriptions are correct?

Keep a list of your current medications with you at all times. Include the brand or generic name, dose and frequency. Paper, online or on your phone – wherever it's easiest and most accessible. Put a paper list in your wallet to cover you in emergencies, consider that even if you use your phone routinely.

Cross-check and update your medicine list with your provider at every visit. This is called "medication reconciliation," It is one of the most important things you can do at a doctor visit. You would be shocked how many patients come to a visit without knowing the names of the drugs they are taking. When the doctor prescribes a new medicine, how can he/she be sure it doesn't interact badly with something you are already taking? If the doctor is lucky, your pharmacist will pick it up, but only if you've filled a prescription in his/her system before. Don't leave it to chance. Take charge.

Ask for an updated list of your medications and prescriptions before leaving your doctor's office. Most electronic medical records (EMRs) can create a current medicine list, so ask your doc or his/her staff for a copy. If you use it as your medicine list to carry with you, everyone will be on the same page. Alternatively, if your practice gives out an AVS (after visit summary) at checkout, that usually will have your medicine list on it.

If you're tech savvy, use the practice patient portal. Your provider's practice portal has a medicine list. Take it upon yourself to check the portal between visits to be sure your medicine list is up to date and correct. You can usually print your medicine list yourself from the patient portal.

Cross-check every medicine after you pick it up against the prescription your provider wrote. This includes refills. Use your printed medicine list, the portal or your AVS to check what your provider wants you to be taking. If you don't have that, you can ask the pharmacist for a copy of your prescription. Don't wait until side effects occur, as my patient did, to double-check. Your health is too important for that.

Don't hesitate to speak up if you think a prescription is wrong. You take it once a week, and now it says twice a week? Say something. And it's not just the pharmacist who can make a mistake. Your doctor isn't perfect either. In fact, since doctors started using the EMR to write prescriptions, mistakes can easily happen. So please, stop the doctor if you think it is wrong.

Finally, don't forget that so called "natural" supplements are medicines too. Some doctors are very adverse to 'natural' supplements. Other doctors are accepting them, but are concerned about the ones they are not told about because of the conflicts between 'natural' supplements and prescription medications. If you're taking any kind of supplement, vitamin, herb or natural product, be sure to add it to your medication list.

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