Medication Risk: Becoming an Informed Healthcare Consumer
Medication Risk: Becoming an Informed Healthcare Consumer
May 8, 2023
Joy Stepinski, MSN, RN-BC
Medication safety is paramount when considering one’s overall health. Many professional and federal organizations outline details on their websites (such as the FDA and CDC). The Agency for Healthcare Research and Quality (AHRQ) explains that with improvements in available therapeutics, there are corresponding risks [1]. Medication errors and adverse drug events are two major concerns. A medication error can happen at any point, including at the time that the healthcare provider prescribes the drug, upon the pharmacist filling the prescription, or from the patient not receiving sufficient instructions. An adverse drug event (ADE) may be experienced by the patient as a direct result from a medication. Although ADEs may not involve an error, approximately half occur as a result of preventable harm.
The numbers show the importance of paying attention to medication safety. One-third of American adults take 5 or more medications. ADEs are the cause of 700,000 emergency department visits and 100,000 hospitalizations annually. The World Health Organization [2] shares that four in 10 patients are harmed globally in outpatient and primary care settings, and 80% is preventable. The most damaging harm is linked with diagnosis, prescriptions, and medication use.
One article shares helpful insight on “rules” for safer drug use [3]. These include:
1. Have “brown bag” sessions with your doctor. Gather all your medications, over-the-counter drugs, and supplements, and review them with your healthcare provider. Create a list so that you have a detailed record (see attached). Know how each drug interacts with the others, understand side effects and for what symptoms to watch, and evaluate whether or not the medication is effective.
2. Make sure that the drug is really necessary. Try nondrug options first, such as diet and lifestyle. Changing the food you eat and developing an exercise routine, among other lifestyle factors, can drastically help health conditions. Inquire if the benefit outweighs the risk and how many people benefit from the drug. The treatment should not be worse than the disease itself. The number needed to treat (NNT) is an estimate of the number of patients needed to be treated in order for the treatment to have an impact on one person [4]. Furthermore, when the amount of medication is limited, the potential side effects and adverse drug events can be lessened. Finally, medications should not be prescribed to address the side effects of another drug.
3. Most of the time, the medication should be started at the lowest dose possible. With elderly patients, the authors suggest that the healthcare provider prescribes one-half to one-third the adult dose, monitor for side effects, and increase the dose slowly to the amount desired.
4. When the doctor adds a new drug, ask him/her to eliminate any medication that is not necessary. This is a good opportunity to avoid potential drug interactions and review the current medication list.
5. Ask your healthcare provider to review your medication list two to three times per year. Sleeping aids, antidepressants, and other similar medication should be reevaluated more frequently because these drugs can cause dependency and have withdrawal effects. They should always be discontinued under a physician’s guidance. Antibiotics should be taken only as absolutely necessary.
6. Learn about your medication and the potential side effects. Medications can affect other systems in your body than the issue intended for treatment. Sites like drugs.com or rxlist.com review side effects and drug interactions.
7. Assume that any new symptom that develops after a new medication is started is the result of the medication.
8. Ensure that you have clear instructions about the medication before you leave the pharmacy. Communicate these to your family or friend. The medication should be well-labeled with a corresponding instruction sheet.
9. Pay attention to expiration dates and discard any outdated medication. Once they are outdated, the drugs may not be as effective and may even be harmful. Do not take any medication offered to you by a family member or friend. These may interact with the medication you already take.
10. Ask your primary care provider to coordinate your medication use instead of having multiple prescribers.
When visiting your healthcare provider, do not hesitate to ask questions about your medications, their potential side effects, and the percentage of people who benefit. Find out about alternative non-medication treatments (like lifestyle changes). Part of being an informed healthcare consumer is to seek information and grow in knowledge!
References
1. Agency for Healthcare Research and Quality. (2019). Medication errors and adverse drug events. https://psnet.ahrq.gov/primer/medication-errors-and-adverse-drug-events
2. World Health Organization. (2019). Patient Safety. https://www.who.int/news-room/fact-sheets/detail/patient-safety
3. Worst Pills, Best Pills. (n.d.). Ten rules for safer drug use. The Public Citizen. https://www.citizen.org/article/ten-rules-for-safer-drug-use/
4. The NNT. (2022). The NNT, explained. https://thennt.com/thennt-explained/