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Estimated between Tue. Estimated delivery dates - opens in a new window or tab include seller's handling time, origin ZIP Code, destination ZIP Code and time of acceptance and will depend on shipping service selected and receipt of cleared payment - opens in a new window or tab. While drug labels vary by pharmacy, an examination of those labels does reveal similarities. For example, the most prominent item on a drug bottle label is the pharmacy name, the second most prominent is the pharmacy telephone number, and the third is the number of refills, Wood stated.
As Wolf reported previously, 46 percent of patients misinterpret at least one instruction on a prescription bottle label. Table provides examples, taken from a study by Wolf and colleagues, of how patients misinterpret instructions. The situation becomes even more complicated with multiple medica- tions.
For example, assume a patient must take three medications daily, one medication three times a day TID , a second medication four times a day QID , and a third medication twice daily BID. The schedule for taking such medications might look as shown in Table If such a schedule were followed for the example illustrated in Table , rather than taking medication eight times a day, the patient would take medication four times a day at the times shown in Table TID med p.
QID med p. BID med p.
Prescription Drug Labeling Medication Errors: A Big Deal for Pharmacists
QID med a. Noon p. Wood reported that a study by Wolf demonstrated that 77 percent of prescriptions could be easily accommodated by the UMS personal com- munication, Michael Wolf, Northwestern University Feinberg School of Medicine, October Audience members asked why not specify time intervals e. In response, Wolf pointed out that studies have shown that hourly intervals are less well understood by patients.
Furthermore, studies using a medication bottle with a chip in the cap that registers when a patient opens the bottle demonstrate that even with specific timed directions for taking a drug, patients do not follow those instructions. One question is whether a UMS would improve understanding. However, as stated in response to a question from the audience, further studies are needed to test the UMS effect on patient understanding. The UMS also produces an additional benefit: the ability to move to a standard prescription form that would have a schedule that includes breakfast, lunch, dinner, and bedtime see Figure The standardized prescriptions could then be translated readily onto a standard label on the prescription bottle.
Patients, pharmacists, and physicians would all use the same schedule. Additionally, if such a system were adopted, clinical trials of drugs could use UMSs in pivotal clinical trials for FDA approval. Currently, different trials may have different times when drugs are administered as long as the studies adhere to a defined schedule for administration.
Furthermore, concentrations vary enormously among individuals because of biological variability and metabolizing activity. Concentrations can also vary within the same individual because of dietary intake.
Standardizing Medication Labels
In response to questions from the audience, Wood emphasized that the UMS does not remove the need to provide warnings such as can be found on auxiliary labels. It is a system for standardizing the times at which one takes medicine. There are some instances when, for example, taking the medication with certain foods or juices can vastly change the effect of the medication. For those medications, additional instructions should specify which foods to avoid. Wood concluded that, as data presented in this workshop show, the current situation of drug labeling is unsatisfactory. Prescriptions are unclear.
Transcription of a prescription to the label is imperfect. Patients frequently misunderstand the drug label. Finally, variability and complex- ity of labels are excessive. The potential advantages of the UMS include a simplified dosing schedule with no loss of efficiency, improved patient understanding and patient adherence, reduced errors, reduced variability, and improved therapeutic outcomes.
Medications are an important component of health care, but each year their misuse results in over a million adverse drug events that lead to office and emergency room visits as well as hospitalizations and, in some cases, death. As a patient's most tangible source of information about what drug has been prescribed and how that drug is to be taken, the label on a container of prescription medication is a crucial line of defense against such medication safety problems, yet almost half of all patients misunderstand label instructions about how to take their medicines.
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