Much medicine is administered and taken within the walls of hospitals, but not all of them are prescribed by the hospital. Many of the medicines being administered by hospital staff are medicines that the patient continues taking during hospitalization. Patients admitted to the hospital don’t always do a good job of telling which drugs they are already taking, which presents a huge window for error as they may not be logged. These same drugs may present adverse reactions in combination with newly prescribed drugs given during the hospital stay.
Simply put, the more medicines a patient takes, the more challenging it is to effectively and safely treat the patient. Drug-drug interactions and drug-disease interactions significantly increase with every additional medication. Studies show that it is common for patients to be on nine or 10 different medications when they arrive at the hospital. According to the Institute of Medicine, medication errors occur at the rate of one per patient, each day in hospitals. Considering that these errors can result in death, this number is exceedingly high.
A growing number of physicians believe patients should stop all home medicines during hospitalization. In fact, the advice goes one step further by recommending that patients not resume any home medicine at discharge unless there is a new doctor’s order in place. This logical solution will increase hospital efficiency and safety, and save Americans a significant amount of money in the long run.
If the benefit of a home-drug outweighs the risks of briefly stopping its use, it would be logical to continue taking the drug while in the hospital. However, this is generally the exception rather than the rule. The shocking reality is that many medications are completely unnecessary, or altogether inappropriate for a particular individual or condition. A recent US study found that 42.6 percent of older adults are on at least one inappropriate medication.
Of course, in order for this plan to work, there has to be significant clinical oversight and decision-making with regard to stopping home medications during hospitalization. Patients should be involved in the decision making process, but clinical judgment should override any decision. Guidelines could be set to make the process as smooth and safe as possible. For example, there could be two lists – one composed of medications that will not be stopped during hospitalization, and one with common candidates for stopping in ordinary circumstances. The first list would likely include drugs that affect an individual’s survival, such as certain cancer medications, high blood pressure pills, thyroid medication, and HIV medication. It may also include drugs for which a brief stopping period may adversely affect their efficacy, such as medication for depression, psychosis, and severe pain. The second list would likely include medications that manage symptoms rather than survival, such as drugs for general pain, anxiety, Alzheimer’s disease, and heartburn.
Although much of this process will be a gray area that is left up to clinical judgment, having a physician endorse these lists will serve to guide decision-making, and reduce errors as a result of ambiguity. Proponents in the medical field believe that this system will be easier, safer, and much less expensive – all good things in a sometimes complicated, dangerous, and expensive field.
If you have been injured as a result of a hospital medication error, the malpractice team at Berkowitz and Hanna LLC can help. Our skilled, knowledgeable attorneys understand the financial, emotional, and physical pain and suffering that can accompany medication errors. You may be entitled to compensation for medical bills, lost wages, and many other related expenses. Medical negligence costs everyone. Contact Berkowitz and Hanna LLC today for a free consultation.