MEDICAL ERRORS II: Pharmacists Under Increasing Pressure
Nationwide, an increasing number of prescriptions and a shortage of pharmacists has some health experts concerned that prescription errors will become more common in coming years, the Washington Post reports. Fueled by the 1999 Institute of Medicine study that revealed a large number of deaths are caused by medical mistakes of pharmacists, physicians and other health care professionals, several health advocates and experts are taking a closer look at medication errors. State pharmacy boards estimate that between 2% and 5% of the three billion prescriptions pharmacists filled last year included some kind of error, ranging from a simple misspelling to dispensing or instruction mistakes that can lead to death or serious injury. Many critics cite weak oversight of the industry as a primary reason for the increasing number of mistakes. Most states do not require pharmacies to report their mistakes; only North Carolina and Georgia have mandatory reporting laws, and even then pharmacists must only report "significant adverse drug reaction[s]" and deadly errors, respectively. Further, many states do not have limits on how long pharmacists can work or require technicians who help fill prescriptions to be certified. Carmen Catizone, executive director of the National Association of Boards of Pharmacy, said, "Nobody's actually quantified [the scope of pharmacy errors], which is a very big problem. That's really the first step. We're missing the key data to fix the system." But pharmacist Michael Cohen, president of the Institute for Safe Medication Practices, said that government regulators have known about prescription errors for years, adding, "Our state boards and our regulatory authorities are in control of whether errors take place. Why doesn't someone look at these errors and see what needs to be done?"
Addressing the Problem
Pharmacy industry groups attest that millions of prescriptions are filled safely each day, pointing out that many pharmacies review their own methods and have already taken certain safety precautions. Phil Schneider, spokesperson for the National Association of Chain Drug Stores, said, "Pharmacies have well- established operating procedures to monitor the dispensing process in an effort to make sure it is done as accurately and safely as humanly possible." In the meantime, two bills introduced last month in the Senate call for voluntary reporting of medical errors, including medication errors made by pharmacists or technicians. Several states also are examining the issue. In Virginia and Maryland, state boards of pharmacy are looking into using automated dispensing machines or dispensing centers that would handle prescriptions for several stores, and officials are considering requirements for error reporting (Glod, 7/3).