The daily life of pharmacies is complicated by the high number of multi-medicated patients and the lack of direct communication with the doctor in case of prescription errors.
02 November 2024 . Updated at 05:00
Mistakes are part of our life and learning from them is essential to try not to stumble over the same stone again. The consequences of these inadvertent missteps carry consequences of greater or lesser importance depending on the territory in which they occur. In addition to being establishments where drugs are dispensed, Pharmacies act as a barrier against possible errors in prescribing medicines or incomplete information. regarding the dosage or duration of patient treatments.
The Farmaadicta Instagram account (more than 35,000 followers) brought to light a case in which Motivan, a long-term antidepressant, was mistakenly prescribed for gastroenteritis instead of Motilium, a drug indicated to relieve the symptoms of nausea and vomiting . «It is an extreme case, but no one is exempt from the error. We, the doctors, the nurses… And we do not have an action protocol as such, but rather Our function, our daily life and our way of proceeding require us to carry out all the necessary checks in each dispensing», explains pharmacist Nina Villasuso, member of the board of directors of the College of Pharmacists of A Coruña (COFC), who recalls a case during the pandemic, when medical consultations were still done by telephone, in which a woman was prescribed a cream for the nose, instead of for a varicose vein. “It may seem funny or unimportant, but if left untreated you could end up in the emergency room with a deep thrombosis,” he reflects. In addition to this type of failure, Laura Fleire, from the Sol y Mar de Oleiros pharmacy, adds another factor to the equation: the lack of data: «It is relatively common for recipes to arrive with incomplete information.. In this situation there are a number of guidelines
The polymedicated man
The surveillance work of pharmacies is exhaustive, especially taking into account the number of polymedicated people. that emerge as we move towards the top of an endemically aging population pyramid. Dispensing drugs to the same patient for cholesterol, hypertension, arthritis, diabetes… is part of daily life in any pharmacy and in that situation, twice checkthe thorough verification of each case is not an option, but an obligation. «Polimedicated patients tend to be elderly patients and, sometimes, they arrive at the pharmacy without having a clear understanding of the aspects of the treatment, whether its duration or whether there is some type of interaction with other drugs or foods», explains Villasuso. It is at that moment that questions arise focused on reviewing and informing the patient in the clearest way and in which the competence and proximity of the apothecary play a fundamental role. «They can’t be abrupt. They need to see that we make them because we care about them and because they take their medications correctly. Obviously you won’t tell them: “Do you take all this for cancer?”, it’s always better to ask questions that make them feel at ease”, says the member of the COFC, who underlines the importance of “stop with each person, especially in the first dispensing at the beginning of a treatment. For Laura Fleire this pharmacovigilance function is “the added value of our profession, which means that we are not a simple supermarket of medicines”. and assures that “many times it is the doctors themselves who challenge us because they know that in pharmacies we can and must resolve all the doubts” that patients arrive with.
“We depend on them wanting to tell us about their pathologies and this makes the job difficult”
One of the problems that pharmacists face in carrying out their work is the lack of access to the diagnosis or pharmacotherapeutic history of the people who turn to their pharmacies. ”We depend on them wanting to tell us about their pathologies and this makes our work difficult because there are those who are reluctant for various reasons”, considers the COFC member. “There are times when we can sense it from the type of medication, but there are times when it can be prescribed for different indications,” he adds. For this reason, collegiate bodies and professional societies have been asking for greater involvement “for the good of the patient” for years, but they regret encountering obstacles in this sector year after year without achieving any progress. “It was even proposed that the patient himself decide whether we could have this access to his history, but that didn’t work,” laments Villasuso. Fleire agrees with her and is categorical in stating that “the more information we have, the more complete our vision of the situation will be and, therefore, the more useful and better we will be able to take care of patients”.
There are cases in which we can block a prescription with justification, for example when a patient has a generic drug and another that are indicated for the same thing. In more serious cases all that remains is to pick up the phone, but sometimes the doctor’s workload makes this impossible and the patient has no choice but to return for the consultation to remedy this,” he concludes.
Filed in:
The city of A Coruña Oleiros Health Health
Interview: Navigating Prescription Errors in Pharmacies
Time.news Editor: Good morning, and welcome to our special segment on healthcare! Today, we have Nina Villasuso, a member of the board of directors of the College of Pharmacists of A Coruña, and Laura Fleire from the Sol y Mar de Oleiros pharmacy. Thank you both for joining us.
Nina Villasuso: Good morning! Thank you for having us.
Laura Fleire: Good morning! It’s a pleasure to be here.
Editor: Let’s dive right in. In your experience, how serious is the issue of prescription errors in pharmacies?
Nina: Prescription errors can have significant consequences. For instance, I recall a case during the pandemic where a woman received a cream meant for a nose instead of the one intended for varicose veins. While it may seem trivial, untreated conditions can escalate quickly, potentially landing patients in emergency situations.
Laura: Absolutely, and that reinforces the crucial role of pharmacists in verifying prescriptions. The complexity increases, especially with the rising number of polymedicated patients—those managing multiple medications for chronic conditions like diabetes or hypertension.
Editor: That’s interesting. How do you manage the challenges of patients who may not fully understand their medications?
Laura: Communication is key. Many elderly patients don’t always grasp how their treatments interact. This is why we take the time to ensure they understand their prescriptions and how to manage their intake. We have to strike a balance between being sensitive and being thorough.
Nina: It’s essential that patients feel comfortable to share their health concerns and experiences with us, which can sometimes be difficult. We encourage them to ask questions about their medications, ensuring the environment feels safe for discussion.
Editor: The lack of direct communication with doctors seems like a major hurdle. Can you elaborate on how this affects your work?
Nina: Definitely. When prescriptions arrive with incomplete information, or without opportunity for quick consultation with the prescriber, it complicates our role as pharmacists. We often find ourselves needing to fill in the gaps with information we may not have.
Laura: That’s where our vigilance comes in. We continuously check and double-check everything—dosages, interactions. This is not just about dispensing medication; we’re actively safeguarding our patients’ well-being.
Editor: You both describe a very active and engaged role for pharmacists. Is there a sense of appreciation for this role within the healthcare system?
Nina: While our profession isn’t always seen for its proactive measures, we are increasingly recognized for our role in pharmacovigilance. Doctors often refer patients to us with questions, which indicates a growing trust in our expertise.
Laura: I agree. Many doctors understand that we can resolve doubts and complications that arise before they reach them. Our job isn’t just about handing out prescriptions; we’re a vital part of the healthcare network.
Editor: It sounds like you both face significant challenges daily. What improvements do you think are necessary to enhance your work’s effectiveness?
Nina: Better communication systems between pharmacies and healthcare providers would be a significant improvement. If we had access to patient records or a direct line to doctors regarding prescriptions, we could avoid many of these errors.
Laura: Yes, and ongoing training for pharmacists in communication and clinical practices would also help. As the population ages and the number of polymedicated patients increases, we need to continually update our knowledge and skills.
Editor: That’s insightful. Before we conclude, is there a final message you’d like to share with our readers?
Laura: I encourage patients to be open with their pharmacists. Don’t hesitate to ask questions or express concerns about your medications. We’re here to help.
Nina: And remember that our role is to care for your health—consider us not just as dispensers of medicine but as healthcare partners. We depend on communication and collaboration.
Editor: Thank you, Nina and Laura, for your valuable insights. It has been enlightening to discuss the complexities that pharmacies face every day in ensuring patient safety. Your dedication is truly commendable!
Nina and Laura: Thank you for having us!
