Magazine article Drug Topics

R.Ph.S under Critical Media Eye

Magazine article Drug Topics

R.Ph.S under Critical Media Eye

Article excerpt

If pharmacists seemed invisible to the lay news media at times last year, they've been discovered in 1995. And so far. it does not seem to be a pretty picture.

On Jan. 4, ABC-TV's "Prime Time Live" used hidden cameras to document what it said were dispensing errors and counseling omissions in community pharmacies. Anchor Diane Sawyer said that five out of 100 prescriptions the show presented to pharmacies "were filled wrong" and that one-third of the pharmacists did not offer to counsel.

The day before the ABC broadcast, the New York Post reported that in four of 16 drugstores its correspondent visited in New York City, pharmacists were "diagnosing illnesses and selling prescription medicine without a doctor's prescription."

And that same week, U.S. News & World Report came out with a cover story, "What your doctor may not know: The undisclosed side effects of some prescription drugs could hurt or even kill you." While not critical of pharmacists, the article did little to reassure the customer about the products they sell.

Only last summer, two major newspapers and a television network ran stories on pharmacists and pharmacy issues that contained no statements at all from pharmacists or their associations (see Drug Topics, Aug. 22). Many pharmacists may be longing to be undiscovered.

Results not surprising

ABC used Kenneth N. Barker, head of the department of pharmacy care systems at Auburn University and an authority on medication errors, to design and evaluate its study.

Barker told Drug Topics that he was not surprised by the results, which were consistent with the 3%-4% error rate he had found in previous studies of outpatient hospital pharmacies. He said that community pharmacies are often poorly designed and that pharmacists are frequently interrupted by phones, patients, and clerks. "The situation in which they work has a number of factors in it that involve distractions, and you should not be surprised that there are mistakes," Baxter said.

Michael Cohen, cofounder of the nonprofit Institute for Safe Medication Practices, agreed that interruptions and environmental factors are a problem and that they are "frequently beyond the individual pharmacist's control."

Cohen said that, in his opinion, the "end point of blame focused on the pharmacist" without ever mentioning some of the product problems that contribute to errors--among them, similar names, labels, or packaging.

The TV study found four dispensing mistakes and one case of illegal generic substitution out of 100 prescriptions involving either Coumadin (warfarin), Theo-Dur (theophylline), or Tegretol (carbamazepine). Sawyer estimated that, at that rate, there were over 274,000 prescription errors daily. "Pharmacists we spoke with all over the country agree that for every one mistake we hear about, there are thousands more," Sawyer said.

Human error

The mistakes filmed by hidden TV cameras involved a Kmart pharmacist in New Jersey, who dispensed Coumadin with instructions on the label for one tablet daily instead of every other day--as was indicated on the prescription--and a Kmart pharmacist in Florida, who dispensed an underdose of Theo-Dur.

Mary Lorencz, manager of public and issues communications for Kmart Corp., acknowledged to Drug Topics that the two prescriptions were incorrectly filled. But, Lorencz went on to say, the 56 million prescriptions that Kmart pharmacists fill annually are representative of the trust the public places in them. …

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