Communication is key to reduce drug interactions

Determine exactly what the patient is taking

Since medication errors and drug interactions are a leading cause of patient harm, how do you make sure it never happens to your practice? When the Medical Group Management Association (MGMA) conducted an informal survey of its members, respondents cited drug interactions as the second biggest risk in office-based practices.

The issue is complicated by the fact that patients often see more than one specialist, explains Fay Rozovsky, JD, MPH, senior vice president at Marsh Inc., a Philadelphia firm specializing in insurance and risk advisory services, and practice leader for the company’s Project MindShare in Richmond, VA.

"The doctor who prescribes one drug may not be in communication with another doctor seeing the patient, and the patient ends up getting drugs that counteract each other," she says.

But there are other scenarios that could also result in adverse reactions to medications. For instance, a patient may be taking an antibiotic prescribed by a dentist following a root canal. Or they may be taking herbal remedies from a naturopath that interacts with the medication a physician prescribes. Special health food diets, over-the-counter remedies, and medicine given to them by a friend could also cause problems if you aren’t aware of them, Rozovsky points out.

"Just asking a patient, What did your doctor prescribe to you?’ is a loaded question," she says. Instead, talk to the patient frequently about what he is taking. Make it clear what you mean by medication. Point out the dangers of sharing prescription drugs. "Ask the right questions and give illustrations to the patients about what you mean," she advises

Rozovsky suggests developing a survey with specific questions on what patients are taking. The questionnaire could be given to patients as part of the introduction to your medical practice and repeated each time a patient visits.

Consider having a brown-bag day. Encourage your patients to bring in all the drugs and over-the-counter remedies they are taking. Go through them, and make sure they are taking the right things in the right sequence, she says.