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Submitted by PatientsEngage on 20 February 2023
Picture of a capsule with text Safety and overlay of text How to prevent medication errors

Globally, as many as 4 in 10 patients are harmed in primary and outpatient health care. Up to 80% of harm is preventable. The most detrimental errors are related to diagnosis, prescription and the use of medicines. This article highlights tips that patients and their family caregivers must follow to prevent medication errors at home. 

What are Medication Errors?

Medication error has been defined by the National Coordinating Council for Medication Error Reporting and Prevention as “Any preventable event that may cause or lead to inappropriate medication use or patient harm, while the medication is in the control of the health care professional, patient, or consumer.” 

The most common causes of medication errors are:

  • Poor communication between your doctors.
  • Poor communication between you and your doctors.
  • Drug substitution at the Pharmacy 
  • Illegible hand-written prescriptions.
  • Missing information about co-prescribed medication.
  • Lack of or unable to follow proper instructions on how to medicate.
  • Drug names that sound alike.
  • Medications that look alike.
  • Medical abbreviations or short forms.

Whenever you start a new medication, make sure you know the answers to these questions:

  • What is the brand and generic name of the medication?
  • What is the medication supposed to do? How long will it be until I see results?
  • What is the dose? How long and when (time of day/ before or after food) should I take it?
  • What should I do if I miss a dose?
  • What should I do if I accidentally take more than the recommended dose?
  • Are there any foods, drinks, other medications or activities I should avoid while taking this medicine?
  • What are the possible side effects? What should I do if they occur?
  • Will this new medication interfere with my other medication(s)? If so, how? If you are unable to understand the written prescription, ask for a printed copy or clarification.

Here's what you need to tell your doctors or health care professionals

  • The name, strength and dose of all medications you're taking including prescription medications, vitamins, nutritional and herbal supplements, or any other over-the-counter drugs you self-purchase. 
  • Inform your doctor on vaccination updates, recent interventions such as bolus IV or vitamin injections. Mention your regular follow-ups and reports of recent tests. 
  • Remember to always alert your HCP (Health care professionals) about allergies to any medications, dyes etc.  If you have had an adverse event following a treatment or during a diagnostic, always make a note of it. 
  • Mention all chronic conditions and medications you are taking for these conditions. 
  • If you are currently pregnant or planning to get pregnant

Avoid these mistakes

  • Some commonly seen medication errors. Don't make these same mistakes
  • Chewing a tablet or capsule is not always as good as swallowing it. Some medications should never be chewed, cut or crushed. Doing so may change how they are absorbed by the body.
  • Never cut/break the tablet/capsule unless your doctor or pharmacist has told you it's safe to do so. Some medications shouldn't be cut because they are specially coated to be long acting or to protect the stomach.
  • Do not use kitchen spoons to take liquid medication. The spoons you use daily are not measuring spoons. To get an accurate dose, use a measuring spoon, an oral syringe or the dose cup that comes with the medication.
  • Confusing eardrops with eyedrops. Always double-check if a medication is for the ears or ophthalmic for the eyes. 
  • Never discontinue any medications without first getting approval from your doctor. Stopping of certain drugs such as antibiotics may lead to resistance whereas abruptly stopping steroids may cause severe withdrawal issues. If you are having financial problems paying for the medications, do not stop taking medications but discuss with your doctor about ways to reduce medication costs.
  • Go for regular follow ups and get a fresh prescription from your doctor when you go on follow ups. (Sometimes medicines and dosage need to be changed over time)

Pediatric medications 

  • Avoid purchasing OTC (Over the counter) meds without first consulting the Pediatrician. 
  • Never give babies and children medications/vaccinations that are meant for adults. Pediatric medicines are specifically dosed by age and weight. 
  • Before giving medicines, confirm dosing for babies or infants, and know the possible side-effects to watch out for. 
  • Double check before purchase. Some drugs have similar names but have different strengths such as Colicaid and Colicmex, which are both used for colic. 

Get into the Habit of Being Safe with these medication tips:

  • Keep an up-to-date list of all your medications, i.e. drugs, vitamins, supplements, herbal remedies 
  • Store medications in their original labelled containers and minimise clutter to avoid mix up .
  • Keep your medications organized by using a box with compartments and labelled for dose/time or an automatic medicine dispenser.
  • Always take the medications on time.   Prevent skipping of medications by taking them at the same time and/or putting a reminder on your fridge door or phone.
  • Keep all documents that come with your medications safe.
  • Try and use the same pharmacy, if possible, for all of your prescriptions.
  • When you pick up a prescription or it gets delivered, check that it's the one your doctor ordered.
  • Don't give your prescription medication to someone else and don't take someone else's.
  • A second pair of eyes to check Prescription: Get into the habit of getting your prescription rechecked by a pharmacist/technically qualified person/caregiver or even a more informed family member. 
  • LASA – Look Alike Sound Alike drugs – Be aware of any similar appearing and spelling of drugs and reconfirm this at time of ordering or purchase.
    For example Pronim containing Nimesulide is a pain and fever reducing drug and Pronil containing Flouxetine is an antidepressant that needs a prescription. Celin is Vitamin C while Celib (Celecoxib) is used to treat pain and inflammation in osteoarthritis and needs a prescription.
  • Always write prescription down or send a photo to the pharmacy at time of purchase.
  • For online orders, make sure you select the right medications and recheck before placing the order.
  • As a patient/ caregiver, get involved in purchase of medication - Open the bag and bottles; is this what you were expecting? Look at the label, look at the name of the drug. If it is a refill, make sure it’s what you got the last time.
  • Best to refill prescription at least 2-4 days before they are over, so you never run out.
  • Always wash hands before taking all medications especially ointments and eye drops.
  • Always check the expiration date on the medications when buying and before taking them.
  • If you have insurance coverage, read up on what you are eligible for and check with your company before starting any new medications.
  • Avoid taking any over-the-counter medications that may counter-act with your existing drugs.

Spot Medication Errors EARLY!

"Don't ask, don't tell" is never a smart policy when it comes to medications and your health. Don't hesitate to ask questions or to tell your doctor/pharmacist/health care providers if anything seems amiss. 
Remember, you are the final line of defence against medication errors.

References:

  1. https://newsnetwork.mayoclinic.org/discussion/medication-errors-cut-your-risk-with-these-tips/ Last accessed on 18th November 2022
  2. https://www.drugtopics.com/view/10-strategies-reduce-medication-errors Last accessed on 18th November 2022
  3. https://www.amcp.org/about/managed-care-pharmacy-101/concepts-managed-care-pharmacy/medication-errors Last accessed on 18th November 2022
  4. https://www.fda.gov/drugs/information-consumers-and-patients-drugs/working-reduce-medication-errors Last accessed on 18th November 2022
  5. Slawomirski L, Auraaen A, Klazinga N. The Economics of Patient Safety in Primary and Ambulatory Care: Flying blind. Paris: OECD; 2018 http://www.oecd.org/health/health-systems/The-Economics-of-Patient-Safety-in-Primary-and-Ambulatory-Care-April2018.pdf.