Health news: prescription drug alert

Black Enterprise, August, 1998 by Valerie Lynn Gray

Errors made at pharmacies could threaten your health

John Fleming was midway through his 30-day prescription for blood pressure medication when he noticed something peculiar. There were only five pills left in the medicine bottle, not the 15 he should have had.

"I called the pharmacist and told him," says the 54-year-old director of the National Afro-American Museum and Cultural Center in Wilberforce, Ohio. The pharmacist's response: "Oh, we're sorry just come in and get the rest of the pills."

Fleming later switched pharmacies, but his problems persisted. He began feeling light-headed after starting a new prescription called Lopressor, a drug designed to control blood pressure.

"Turns out this pharmacist had given me 25 milligrams of the drug, not the 50 milligram doses my doctor prescribed," recalls Fleming. "The pharmacist was very apologetic, but I was upset. What happened wasn't lifethreatening at that point, but it certainly impacted how I felt." If Fleming had continued taking the drug at the wrong dosage, however, he may have been at risk for a stroke.

Consumers like Fleming are wondering why pharmacists can't seem to follow doctors' orders when it comes to dispensing medication. In some instances, patients are shortchanged on the number of pills or in the dosage prescribed. In more serious cases, patients can receive the wrong medication, with fatal results. An estimated 100,000 people die from prescription drug use every year, according to a study reported in the Journal of the American Medical Association.

These errors stem from the great changes sweeping the pharmacy industry. Hospitals and large-chain drugstores have cut staffing to hold down costs and increase profits. At the same time, pharmacists' workloads have increased due to the additional paperwork required by insurance companies.

This is a major reason for the errors and slow service consumers face at the pharmacy Counter, says Michael Hogue, a pharmacist 'In Albertville, Alabama, and member of the American Pharmaceutical Association. "Your pharmacist literally becomes an insurance agent. While dispensing medication, he or she is likely to be on the phone trying to process your insurance claim."

In the case of Fleming's short supply of blood pressure medication, Hogue says it's likely the insurance carrier had a limit on the quantity that could be dispensed at one time. "Most consumers don't realize that their insurance company won't allow for more than a 15- or 30-day supply of medication. Whenever you get fewer pills than prescribed, ask the pharmacist if your insurance carrier has limits on that prescription," advises Hogue.

And what about the wrong dosage Fleming received? Hogue blames poor management at many of the large-chain drugstores. "Many of the chain pharmacies are not managed by a pharmacist who understands the need for time to process an order. They may be managed by someone who puts pharmacists under lots of pressure to fill orders quickly, and that leads to errors."

Larry D. Sasich, a pharmacist and analyst with the Washington, D.C.-based Public Citizen Health Research Group, a watchdog organization for consumer health issues, calls it the prescription milt. "There may be one pharmacist behind the counter and two technicians. That pharmacist may have to fill 200 prescriptions a day on a 12-hour shift with no breaks or no lunch," he says.

"Our managed care system doesn't work very well to protect consumers against drug-induced injuries," says Sasich. "Consumers must be vigilant about what they're getting from their pharmacist."

Start monitoring your medications before you leave your doctor's office. "Ask your doctor both the brand name and generic name of the drug prescribed, the dosage required and why it's being given," counsels Sasich. "When you get the prescription from the pharmacist, read the label to make sure you've been given the drug your doctor prescribed and that the dosage is correct." Also make sure that the pharmacist gives you the FDA-approved package insert or computer printout that outlines information about the drug you've been prescribed, dosage directions, adverse reactions and side effects, drug-to-drug interactions and other precautions.

You can also protect yourself by asking your pharmacist about some key points before you head home with your prescription in tow. Here are some suggested questions from the National Council on Patient Information and Education, in Washington, D.C.:

1. What is the name of the medicine and what is it supposed to do?

2. How and when do I take the medication and for how long?

3. What foods, drinks, other medicines or activities should I avoid while taking this medication?

4. Are there any side effects, and what do I do if they occur?

5. Will this prescription work safely with the other prescription and nonprescription medicines I'm taking?

For more information on getting the right medication from your pharmacist, contact the Agency for Health Care Policy and Research (AHCPR). To order a free copy of the brochure Prescription Medicines and You, write to AHCPR Publications Clearinghouse, P.O. Box 8547, Silver Spring, MD 20907, or call 800-358-9295. The National Council on Patient Information and Education offers a free pamphlet, Get the Answers. To order, call 202 347-6711.