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Dynamic Chiropractic – September 14, 2006, Vol. 24, Issue 19
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More Bad News About Medication Errors

IOM Report: 1.5 Million Injured or Killed Annually

By Stephane Babcock

The high cost of medical mistakes can increasingly be calculated in lives and dollars. According to the latest estimates from the Institute of Medicine (IOM),1 a staggering 1.5 million Americans are the victims of medication errors every year, with approximately 400,000 of those errors considered preventable.

The 2006 IOM estimates are distinctly higher than previous estimates that projected between 380,000 and 800,000 preventable adverse drug events occurring annually.2

"The frequency of medication errors and preventable medication-related injuries represents a very serious cause for concern," states the report. "The committee estimates that on average, a hospital patient is subject to at least one medication error per day at least one quarter of all medication-related injuries are preventable." Those errors contribute directly to injury and/or death.3

Reports of medical errors have become commonplace in the past decade. In 1999, the IOM published its original report, To Err Is Human, which estimated that between 44,000 and 98,000 people die from mistakes made in hospitals each year, with an estimated 7,000 of those deaths being the direct result of medication errors.4 Costs related to these incidents also have risen, with a conservative estimate of $3.5 billion spent annually, according to the 2006 report.3 A 2004 analysis of billing information for 37 million Medicare patients by HealthGrades, a health-care-quality company, estimated that 16 types of patient safety errors resulted in an estimated $19 billion in extra costs and nearly 200,000 unnecessary deaths in hospitals across the U.S. between 2000 and 2002.5

In 2003, a study in the Journal of the American Medical Association6 suggested that 27 percent of all adverse drug events experienced by Medicare patients age 65 and older were preventable, and that "most" were attributable to doctor error. In terms of severity, nearly 40 percent of the events were considered serious, life-threatening or fatal, 42.2 percent of which were deemed preventable. The study authors projected their data nationwide, estimating that in the elderly population, "there are in excess of 180,000 life-threatening or fatal adverse drug events per year, of which more than 50 percent may be preventable," and adding that "these estimates are likely to be conservative."

The 2006 IOM report, sponsored by the Centers for Medicare and Medicaid Services, lists several potential causes of medication errors, including unexpected drug interactions, inadequate methods for generating and relaying information about medications, mislabeling, and incorrect doses. The report outlines a "comprehensive approach" that could help to prevent such mistakes from occurring. "This approach will require changes from doctors, nurses, pharmacists, from hospitals and other health care organizations, and from patients."2 The IOM report splits the recommendations into four areas: personal/home care, ambulatory care/outpatient clinic, pharmacy, and hospital inpatient care.7 One of the recommendations concerns greater involvement of the federal government. The recent passing of H.R.4157, a bill designed to accelerate the use of electronic health records and e-prescription systems, may be a sign the government is taking action when it comes to medication errors.8

While doctors of chiropractic are "drugless practitioners" by their very nature, most recognize that under certain circumstances and for certain conditions, patients may require traditional medical intervention. The IOM report advises patients to research the benefits and side effects of medications before taking them, and to maintain a list of what prescription and nonprescription drugs, vitamins, and supplements they are taking.1 Patients should take this list with them whenever they visit any health provider.

References

  1. "Medication Errors Hazardous to Your Health." L.A. Times, July 21, 2006.
  2. "Preventing Medication Errors: Quality Chasm Series." Institute of Medicine of the National Academies press release, July 20, 2006.
  3. Preventing Medication Errors. Institute of Medicine report brief, July 2006.
  4. "New Study Shows Growing Consumer Dissatisfaction With Medical Care." Dynamic Chiropractic, Jan. 9, 2005.
  5. "Medical Errors Make the Headlines Again." Dynamic Chiropractic, Sept. 27, 2004.
  6. Gurwitz JH, Field TS, Harrold LS, et al. Incidence and preventability of adverse drug events among older persons in the ambulatory setting. JAMA 2003;289(9):1107-16.
  7. "What You Can Do To Avoid Medication Errors." Institute of Medicine of the National Academies fact sheet, July 2006.
  8. "U.S. House of Representatives Passes Health IT Bill." Information Week, July 28, 2006.

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