Wednesday, October 07, 2009

Family caregivers and prevention of medication errors: what is written about this problem?

I took a look online at the subject of family caregiving and the potential for medication errors, and the best lay reference that I found was on Stan Cohen’s “Maturity Matters” with a Wordpress article, “Safe medication and aging: 6 challenges to overcome medication errors,” link here.

He concentrates mainly on “low tech” solutions like pillboxes, large labels, and other delivery systems, and making pills easier to swallow (many non-prescription multi-vitamins are huge!) One big help would be a system that inventories by weight the number of pills that remain, so that a caregiver can know at any time if a correct dose has been maintained. Mechanical systems might be needed to keep medication locked up. Some medications (like Coumadin) require constant blood monitoring, and the numbers from such tests (INR’s) can be erratic under the best of circumstances.

But the president is right: physicians, especially those caring for the elderly, need an automated system for tracking what medications other physicians have prescribed. There is no reason why a company like EDS, Perot or IBM could not develop and install such a secure system within the privacy requirements of HIPAA. Unpaid family caregivers should not be grilled into second questioning physicians, although some physicians sometimes may be under pressure from drug manufacturers to over prescribe.

A promising innovation may be the CapsulCard (as trademarked) (link).

Not much shows up on the potential legal liability for non-professionals for medication errors, but it clearly may be comforting to some caregivers to see medication administration done by nursing professionals in a controlled setting. Assisted living centers typically charge over $300 a month to manage medication, so the responsibility is not trivial. This is definitely an issue to address in our health care policy debate.

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