The stroke that shouldn't have been

April 10, 2016

Molly’s mom had a stroke, followed by hospitalization and weeks of rehabilitation. None of it had to happen.

Ken BakerMolly’s mom had a stroke. The stroke was followed by hospitalization and weeks of rehabilitation - all because Molly’s mother had a stroke. Molly’s mom did not have to have a stroke. It could have been prevented, if she had taken her blood pressure medication as prescribed.

See also: Can pharmacists be sued for doing their jobs?

The story of Molly’s mom

Molly’s mother, a widow, had extremely high blood pressure. Her physician prescribed one of the newer medications, which did reduce Molly’s mom’s hypertension, but it was expensive. It was not covered by her insurance.

The prescription was written for 30 tablets, with the directions to take one a day. Molly’s mother lived on a very limited income. The cost of the medication meant that she often had to choose between buying food and filling her prescription.

Molly’s mom did not tell Molly, her physician, or her pharmacist that she could not afford this medication. To save money, Molly’s mom began taking her medicine every other day. Later it became every third day.

When she wasn’t taking a pill every day, no one said anything. As a matter of fact, no one appeared to notice at all.

A few months after she began reducing the dosage of her medication for high blood pressure, Molly’s mom had a stroke. It was relatively minor, but she was hospitalized for several days and that was followed by weeks in rehabilitation.

The hospitalization and rehabilitation were paid for by the insurance company that would not pay for the medication that could have prevented the need for both.

See also: The importance of the pharmacist in everyday practice

Did it have to happen?

Could anyone have intervened and prevented Molly’s mom from having a stroke? Maybe Molly, maybe the physician, and maybe the pharmacist and pharmacy’s technician.

Since we are pharmacists and technicians, let’s look to the pharmacist and pharmacy technician for an answer to the question.

The pharmacy code of ethics says, “A pharmacist [pharmacy technician] promotes the good of every patient in a caring, compassionate, and confidential manner.”

The law of every state says, “The pharmacist shall perform a prospective drug review prior to dispensing any prescription.” It does not say, “prior to dispensing only a new prescription.”

 

What didn’t happen

The pharmacist and the pharmacy technician at the pharmacy where Molly’s mom filled her prescription could have discovered that their patient was not seeking refills of her medication as prescribed. Each time the prescription was refilled that information was available.

Had the pharmacist or the pharmacy technician noticed that the 30-day supply of medicine was lasting 60 days and later 90 days, they could have alerted Molly and her mother’s physician before the stroke and the injury occurred.

Pharmacists and pharmacy technicians have the ability in their daily professional lives to make a real difference in the lives of their patients. Sometimes we have to be reminded of how we do that and how important it is.

Epilogue

After Molly’s mom had the stroke, her prescription was changed to a less expensive, older blood-pressure prescription. Molly now pays for her mother’s medication each month.

The new prescription of the older medication is working fine for Molly’s mom,  just as well as the “newer and greater and more expensive” medication that she used to take  - and sometimes did not take.

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