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Massachusetts
Coalition for the Prevention of Medical Errors, The Massachusetts Coalition for the Prevention of Medical Errors, in collaboration with the Massachusetts Medical Society, have jointly announced a health safety initiative for both patients and health care providers to reduce the growing incidence of medication errors. The new statewide initiative includes the promotion of a medication list (Med List) and tips for using medications wisely to patients and their families as well as promotion of a process known as reconciling medications by providers during medical visits.
Reconciliation in the physician office setting involves, 1) comparing the patient’s current medication list with the list in the medical record, 2) making appropriate adjustments, and 3) ensuring the updated list is shared with the patient and the physician coordinating care.
Injuries from medications, known as adverse drug events (ADE), are far too common and costly in today's health care system, and most are preventable, according to experts. The Institute of Medicine estimates that at least 1.5 million preventable ADEs occur in the U.S. every year and cost in excess of $3.5 billion in additional hospital and medical costs.
Med List is a form that promotes patient health and safety through three steps: (1) by helping patients track their use of medications, herbs, vitamins, other dietary supplements and additionally helps track medication start and stop dates, when the medication should be taken, purpose of taking it, if any monitoring is required, and possible danger signs; (2) by assisting patients in discussing their medication history with physicians; (3) by giving physicians more complete and accurate information about a patient's medications to help provide a safer level of care. Med List and the helpful tips for using medications wisely may be downloaded free of charge from http://www.macoalition.org/consumerDirectory.shtml.
Paula Griswold, M.S., Executive Director of the Massachusetts Coalition for the Prevention of Medical Errors, said "Poor communication between patients and physicians during office visits is a significant contributor to medication errors. The physician or nurse practitioner may not be aware of all the medications the patient is taking, or may not know that the patient has stopped taking a medication because he’s experienced side effects. The patient may not know the purpose of her medications, or side effects to watch for that might indicate trouble. The medication list we’ve developed includes reminders that improve communication in order to make care safer.”
As physicians see patients for medical appointments, the Med List is reviewed and decisions made whether to continue, discontinue, or change medications listed. The purpose of the reconciliation process is to avoid medication errors associated with omission, duplication of therapy, drug-drug, and drug-disease interactions. According to the IOM, physicians should educate their patients about the medications they are taking, why they are taking them, what the medication looks like, what time they should take them, potential side effects, and what to do if they experience side effects. Physicians should also remind patients about appropriate medication self-management.
Kenneth R. Peelle, M.D., president of the Massachusetts Medical Society, said "The distinguishing characteristic of Med List is that it can be an important tool for both patient and provider in reducing errors. It allows the patient to be more involved and more of a partner in his or her health care, and it can facilitate and improve communication between patient and provider - a critical element in improving health care and patient safety."
To help transition consumers to completing and carrying a medication list, Brooks Pharmacy is participating in this initiative by providing patient medication profiles as well as making the Med List available to its pharmacy customers throughout 165 Massachusetts stores. The patient profile includes medications filled for the customer and can be used to complete the Med List. Patients may check with other Massachusetts chain or independent pharmacies as they may be willing to do the same.
"Actions for Prescribers," a checklist for inpatient and outpatient providers, nursing homes and assisted living facilities with IOM recommendations for improving medication safety is available to providers at http://www.macoalition.org/initiatives.shtml. Pharmacists may also access the checklist, “Actions for Pharmacists” from the same web site.
Med List was developed with the support of the Commonwealth of Massachusetts' Betsy Lehman Center for Patient Safety and Medical Error Reduction. According to Nancy Ridley, Director of the Betsy Lehman Center, “This is an important initiative that will help make the use of a medication list and reconciling medications a common practice at medical visits for patients and providers across Massachusetts.”
About the Massachusetts Coalition
About the Massachusetts Medical Society The Massachusetts Medical Society, with some 18,500 physicians and student members, is dedicated to educating and advocating for the patients and physicians of Massachusetts. The Society publishes The New England Journal of Medicine, one of the world’s leading medical journals; the Journal Watch family of professional newsletters covering 11 specialties; and AIDS Clinical Care. The Society is also a leader in continuing medical education for health care professionals throughout Massachusetts. Founded in 1781, MMS is the oldest continuously operating medical society in the country. For more information, go to http://www.massmed.org.
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