Letters to the editor: October 9, 2006


Regarding your Aug. 21 article "Reducing drug errors: IOM issues call to action," every effort to reduce drug errors is commendable. But let's not get carried away with tying safety to increased communication or counseling. Distractions cause errors.

When I managed a large mail-service pharmacy, I documented the fact that those pharmacists filling the most Rxs in eight hours had a much lower frequency of errors than those filling fewer prescriptions. Why? Because they allowed fewer distractions. I also documented that female pharmacists were much less prone to error than males-because they seemed less likely to be distracted.

Years later, when I managed a nursing home pharmacy, I documented increased errors during the hour just before deliveries went out. Why? Pharmacists began rushing orders, and their "routine" became totally distracted.

Faxed prescriptions would resolve these problems until we become fully, electronically automated. But too many offices won't use this safer, faster, and more efficient method. Some larger practices acknowledge that "their docs don't write." We and they are left to fend for ourselves. The constant disruption/distraction caused by phone calls that require the pharmacist's immediate attention-never mind that they are usually busy in the dispensing process-are really just "prescriptions for error." So, if IOM really wants to look seriously at preventing Rx errors, look first at the distractions inherent with dispensing.

Paul Bergeron
Lake Monticello, Va.

Puzzled over CE

Your CE article "Screening controlled-substance prescriptions for validity" (Aug. 21) puzzled me as it appeared that the author had a bias against pharmacists. At the outset of the article, such comments as "government-sanctioned monopoly," "sufficiently enlightened pharmacist," and "an ethical tradition..." diverted my attention away from what I had hoped would be information I could use in my practice. I stopped halfway through the article because I could not get beyond the author's writing technique of adding editorial to educational content.

David Theiler, R.Ph.
Marietta, Ga.

Reply from author, David Brushwood: I am so sorry to have created such ill will and certainly did not intend to. Please skip to the end of the article, where I describe VIGIL, a process that can be used in pharmacy practice to screen out drug diverters, teach chronic pain patients that they have important responsibilities, and demonstrate good faith to any regulator who may be watching. The comment about "government-sanctioned monopoly" is a term of art from regulatory theory.

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