Thousands of Americans die as a result of medication errors on an annual basis — and in many cases, the situation could have been avoided if the proper precautions had been taken. In fact, a recent report published in Stat Pearls puts the medication error death toll at between 7,000 and 9,000 people per year.1
What is a medication error, and how is it caused?
A medication error is defined as any preventable event that may lead you to inappropriately take a medication.2 In other words, you may or may not be to blame for the error — but either way, it could cause you harm.
There are several points in the journey between getting a prescription and taking a medication where an error can occur, says Zachary A. Marcum, PharmD. He’s an associate professor at the School of Pharmacy at the University of Washington in Seattle.
“Those points include prescribing a medication, transcribing or documenting it (such as in a patient’s electronic record, as well as transmitting it to a pharmacy), dispensing it, administering the medication, and monitoring its effects,” Marcum says. Anything that goes wrong during any of those steps is deemed a medication error.
Types of medication errors
Types of medication errors that occur at the prescribing or dispensing stages include:3-5
- prescribing an incorrect drug for a condition
- ordering the wrong dose or preparation of a drug
- failing to consider a history of allergic reactions, impaired kidney or liver function, or the potential for drug interactions
When a medication error leads to an adverse drug event (ADE) that harms you, it’s known as a preventable ADE. A medication error that does not lead to harm is known as a potential ADE.6 (See “What are ADEs?” to learn more about adverse drug events.)
But medication errors don’t have to lead to ADEs. You can do a lot as a patient to avoid them. The administering stage is where you come in. And the real secret to keeping the risk of errors low is to tap both your physician and your pharmacist.
Here’s why: In our fragmented health care system, medical information is often siloed, particularly if you see multiple doctors or use more than one pharmacy, says Marcum. Miscommunication can easily lead to errors. For example, one physician could be unaware of a medication you were prescribed by a different specialist. Doctors and pharmacists will each offer you guidance in their own way, and their goal will be the same: to make sure you make the smartest and safest choices.
So the next time you get a new prescription, be sure to ask these five questions before you take your first dose.
1. Why have I been prescribed this medication?
“You should have a general understanding of what a new medication is supposed to do for you,” says Marcum. Perhaps it’s supposed to control your blood pressure or manage chronic asthma. If you’re unsure, or you want more information about a new drug, ask your physician or pharmacist:
- How does this drug take effect in my body?
- What is the best time of day to take this medication?
- Is there a way for me to tell if it is working correctly?
- What should I do if I accidentally miss a dose?
- Which side effects are normal and which are a cause for concern?
- Are there specific times that I should come in for follow-up appointments or to take additional tests?
2. What should I do if my health status changes?
If you’re being treated for a new condition, and especially if you’ve just been released from the hospital, “that’s an important time to review both new and existing medications with your doctor or pharmacist,” says Marcum. “When there’s a change in your health status, your risk profile for the medications you take may also change. What was once safe may no longer be as safe.”
Before you leave a hospital or facility, ask additional questions if anything seems unclear. For example, if you were instructed to stop taking one of your regularly prescribed medications before an operation or other procedure, ask your doctor when it’s safe to start taking it again — or if the dosage needs to be changed.
3. When is it safe to start taking the new medication?
Some medications may feel so benign or common that you wouldn’t think twice about reaching for them, like Advil or Tylenol. But if you’re taking other medications, they may not be so safe.
Tell your doctor or consult your local pharmacist before taking an over-the-counter medication or even a supplement. “You may reach for a nonsteroidal anti-inflammatory (NSAID), like Advil, for a headache, which carries a risk of stomach bleeding,” says Marcum. “That may not have been an issue a year ago, but now you may be on another medication that also increases the risk of stomach bleeding.”
Also, keep a list of all the medications, vitamins, and supplements you regularly take so you can review them at your appointment or at the pharmacy consultation window.
4. What should I do if the medication doesn’t make me feel right?
If you have a serious reaction, like experiencing shortness of breath or hives, contact your physician immediately or dial 911. Otherwise pay attention to how the new drug or dosing schedule makes you feel, even if you think the side effects are mild or tolerable — and tell your physician about those side effects as well. Some may resolve once your body adjusts. If they don’t, it may be possible to lower your dose or switch to a different drug, so make sure to consult your doctor.
5. Is there anything else I can do besides consulting my doctor or pharmacist?
Be your own advocate and learn about the drugs you’re taking and how they may affect you. One option would be researching reputable, patient-friendly websites like Consumer Med Safety, where you can report medication errors and use other helpful tools and resources. If you’re curious about a mental health medication, you can also consult this page.
Another option can be to ask your doctor about whether they’re aware of medication interaction software, like Genomind’s precision medicine software, which is designed to help doctors evaluate your medication profile in one composite view. As the medications are entered and assessed for potential gene-drug and drug-drug interactions, your provider can then direct you to safer prescribing options with speed and precision. You can learn more about it here.
- Info on medication errors and prevention: Medication Dispensing Errors and Prevention (2021)
- Definition of medication error: About Medication Errors (2022)
- Info on medication errors and ADEs: Medication Errors and Adverse Drug Events (2019)
- Info on medication errors and reducing them: Working to Reduce Medication Errors (2019)
- Info on NSAIDs: Guidelines to Help Reduce the Side Effects of NSAIDs (Nonsteroidal Anti-inflammatory Drugs) (2021)
- Info on ADEs: Medication Errors and Adverse Drug Events (2019)