Modern medicines are a powerful tool for disease treatment and prevention. But along with the anticipated benefits there are frequently risks when these medicines are not used appropriately.
According to Dr Romano Fois, “with over 200 million prescriptions dispensed in Australia each year, potentially harmful medication –related incidents are captured and addressed by community pharmacists every day”. Dr Fois is the principal investigator for the inaugural National Medication Safety Week Project (NMSW).
NMSW is an initiative of the Faculty of Pharmacy at the University of Sydney. The project will encourage pharmacists to not only identify and rectify possible problems, but also to document and report these incidents so as to design safer systems of care.
It’s estimated that up to 3% of all hospital admissions are related to the use or misuse of medicines. Apart from the direct impact on a person’s health, the monetary cost of these mix-ups is also significant – thought to be around $660 million in 2008.
One cause of confusion related to the prescribing, dispensing and use of medicines is the similarity of names of different medicines, as well as the multiplicity of names for the same medicine.
More and more commonly used medicines are coming to the end of their patent life; so more so-called generic (and usually less expensive) alternatives to the original brand will become available – these are the alternatives the government is encouraging us to embrace to maintain a financially sustainable Pharmaceutical Benefits Scheme.
It’s important, therefore, that we know our medicines by their generic name, not just the brand name.
In some instances totally different medicines have quite similar names. This is an issue which has recently been addressed by the Australian Commission on Safety and Quality in Health Care (ACSQHC) with its Tall Man lettering project.
Tall Man lettering uses capital letters selectively within the look-alike drug names (for example, the word DilaUDID and DilaNTIN). This project, developed by the ACSQHC, is the first of its kind in the world and aims to reduce the risk of patient harm from similar sounding and similar looking names of medicines.
Meanwhile, researchers from the University of South Australia have identified medication-related risks, not with similar-sounding medicines, but with medicines belonging to the same group – the non-steroidal anti-inflammatory pain relievers (NSAIDs).
Results of the research were published in the 7 November issue of the Medical Journal of Australia (MJA). Using data provided by the Australian Department of Veterans Affairs, information gathered from more than 160,000 veterans indicated prescribing NSAIDs may lead to an increased risk of stroke.
However, in an MJA editorial, David Blacker, Clinical Associate Professor of Neurology at the University of Western Australia, points out that the population studied was elderly, frequently with existing arthritis and heart and blood vessel disease. “It should be remembered that the conclusions do not apply to younger and healthier populations. Additionally, the absolute stroke risk is small, and may be exceedingly small, particularly if NSAID exposure is brief,” he said.
While the group of NSAIDs studied were prescribed medicines, several are available without prescription as well; and there appeared to be different risks associated with different medicines within the group.
Despite these confounding factors, there is a clear message: seek your doctor’s or pharmacist’s advice before self-selecting a pain reliever, especially if you’re taking other medicines and/or you’re in the over 65 years age group.
