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Why is this still happening in the 21st Century?

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Illinois

* I always assumed my massive chain pharmacy’s computer system automatically checks to make sure none of my prescriptions interact negatively with each other. I was wrong…

In the largest and most comprehensive study of its kind, the Tribune tested 255 pharmacies to see how often stores would dispense dangerous drug pairs without warning patients. Fifty-two percent of the pharmacies sold the medications without mentioning the potential interaction, striking evidence of an industrywide failure that places millions of consumers at risk.

CVS, the nation’s largest pharmacy retailer by store count, had the highest failure rate of any chain in the Tribune tests, dispensing the medications with no warning 63 percent of the time. Walgreens, one of CVS’ main competitors, had the lowest failure rate at 30 percent — but that’s still missing nearly 1 in 3 interactions. […]

In Illinois, pharmacists who detect a serious interaction must contact the prescribing doctor to see if the order is correct or if an alternative therapy is available, according to the Illinois Department of Financial and Professional Regulation. Pharmacists are then supposed to alert the patient. […]

Mayuri Patel, a pharmacist at a Wal-Mart in west suburban Northlake, said she typically fills 200 prescriptions in a nine-hour shift, or one every 2.7 minutes.

At another Wal-Mart where she was trained, it was even busier, she said: “We were doing 600 a day with two pharmacists with 10-hour shifts.” That works out to one prescription every two minutes.

You really should read the whole thing. And there’s more coverage at this link.

posted by Rich Miller
Friday, Dec 16, 16 @ 10:54 am

Comments

very frightening. they are the last line of defense for meds mixing. Also disturbing, doctors who don’t know, or don’t recognize a deadly mix. And patients who don’t tell doctors about their meds. at the very least a patient has to share. many systems are now computerized so they keep a record of meds dispensed. but patients can doctor choose in and out of system.
witness so many overdoses with doctor shopping.

Comment by Amalia Friday, Dec 16, 16 @ 11:05 am
People don’t realize the importance of pharmacists - doctor of pharmacy is a 4 year long degree program. Your prescribing doctor forgot most drug interactions 20 years ago. That’s not their focus. If pharmacists don’t catch these mistakes, no one will.

Comment by CVS customer Friday, Dec 16, 16 @ 11:05 am
I picked up on this investigation earlier today.

Very troubling.

I forwarded the link to one of my nieces who is a 4th year honors student at STLCOP. Can’t wait for her to read it and get her reaction.

Comment by illini Friday, Dec 16, 16 @ 11:08 am
Pick up a used copy of Pearson Nurse’s Drug Guide 2014. Or buy a new 2017 edition copy (kind of expensive).

Knowledge matters.

Comment by Judgment Day Friday, Dec 16, 16 @ 11:09 am
@CVS - this is a 7 year program not a 4 year program. And a very, very costly curriculum as well!

Comment by illini Friday, Dec 16, 16 @ 11:11 am
I texted the Tribune article link to my pharmacist son, but he had already read it. His reaction? He tells his customers to stop their statin cholesterol med when starting certain antibiotics. He claims most MDs don’t know about the bad interaction. The patient is faced with starting a new antibiotic after a new script is written (could be 3 days) or stopping their statin for 10 days. Having interned in a couple high volume pharmacies, he doesn’t doubt that those pharmacists fail to point out the bad interaction to their customers. Caveat emptor sadly applies to medicine as well.

Comment by Diogenes in DuPage Friday, Dec 16, 16 @ 11:21 am
The article explains how it’s happening. Profit motive, competition and a combination of pressure, neglect and laziness. Please note, I don’t even mean to argue this is Evil Corporate money-grubbing. I doubt most of these companies were telling people to skip checks or intended for that to happen. It just wasn’t on their minds. Regulation and monitoring of the drug industry (and many others) is not simply about stopping active malice.

I think it’s equally disturbing that the State or Feds didn’t catch this.

Comment by Threepwood Friday, Dec 16, 16 @ 11:42 am
WEBMD.com can do this for you.

Comment by Liberty Friday, Dec 16, 16 @ 11:43 am
Saw this yesterday and found it frightening. Some people take lots of meds and things can go crazy fast when you’re seeing a specialist or 2.

Comment by Belle Friday, Dec 16, 16 @ 12:01 pm
Shame Trib had to go to the trouble. If you can get passed the confidentiality issues, insurers who cover pharmacies would scare you to death with misfill claims. One that I always remembered were two kids with identical names whose parents filled different scripts at the same pharmacy. One was for acidic ear drops and the other for more neutral eye drops. No one, including the parents, double checked the received scripts.The scripts were switched. The eardrops were applied to the eyes with tragic consequences.
Check everything. I’m in the habit of looking up a new script on readily accessible databases. and don’t deal with a doc who can’t write a legible script. Better yet, insist on a computer generated one.

Comment by Cook County Commoner Friday, Dec 16, 16 @ 12:48 pm
Some folks on the state health plans get 90 day prescriptions filled through the mail (like ExpressScripts) and would get a short term prescription, like an antibiotic, at the local pharmacy. The local pharmacy may know nothing about the 90 prescriptions. You need to be your own doctor, sometimes.

Comment by MSIX Friday, Dec 16, 16 @ 1:38 pm
This story is very scary. Unfortunately the problem would be difficult do detect by regulators. An investigator would have to be there watching a pharmacist failing to provide appropriate counseling (which does happen occasionally at surprise inspections). This is really the responsibility of the pharmacy companies to set up better quality controls.

@illini - It’s a 6 year program. 2 years general education and a 4 year pharmacy education program.

@Diogenes - “He tells his customers to stop their statin cholesterol med when starting certain antibiotics.” I sure hope he doesn’t do that. Only the patient’s prescriber may direct the patient to stop medication. Your son should be calling the prescriber and asking her if the patient should stop the drug due to the potential harm of taking both drugs at once. It is the prescriber who decides how alter a patient’s medications. The pharmacist’s job is to advise of the potential harmful interactions and communicate the direction received by the doctor. If the pharmacist makes that decision on his own that the patient should discontinue a prescribed drug, he is practicing medicine.

Comment by Somebody Friday, Dec 16, 16 @ 2:53 pm
I would say this country is too reliant on medication. How many of these drugs are really, truly necessary?

Comment by Ryan Friday, Dec 16, 16 @ 3:39 pm
@Somebody - The St. Louis College of Pharmacy is now a 7 year, and a very rigorous, program. Some may still be doing 6 years, but that is no longer the norm.

Mt niece has worked as a licensed Tech at an independent pharmacy as well as at CVS during summers. She has been working for two years at a major St. Louis hospital and one of her many responsibilities is to check for interactions based on the info available about other meds. Of course, she is not yet responsible, but has caught some possible problems for the Pharmacists to address.

Comment by illini Friday, Dec 16, 16 @ 3:47 pm