Medication safety and human factor – keys to successful pharmacotherapies
Medication safety means that the doctor prescribes the right medicine and the pharmacy dispenses or the nurse administers it correctly to the patient – or the patient knows how to take the medicine in the proper way.
The ultimate objective of pharmacotherapies is to cure or prevent diseases or prevent patients from getting worse as well as alleviate their symptoms.
Human factor is decisive – both ways
Each person needing medicines is unique and individual, and so is the course of the disease that is being treated. Based on the professional expertise, the doctor looks for the best medicine for this combination, excluding any wrong choices.
Human error can endanger medication either in the hospital, at the pharmacy or at home.
In the hospital, the pursuit towards the best treatment outcome may be jeopardised by an error by the doctor or nurse, wrong analysis or treatment routine messed up by a busy day.
At the pharmacy, there may be an error in dispensing the medicine in the prescription, caused by unintentional human error or an omission made possible by the system.
At home, the good outpatient treatment outcome is in the hands of the medicine user. The correctly prescribed and dispensed medicine does not yet guarantee the cure. Only the medicine correctly taken will help. The system does not control the choices of individuals nor guarantee that the user understands the instructions correctly.
How to influence the human factor
Training and education of healthcare professionals are key for the promotion of successful pharmacotherapies and minimisation of their weaknesses. The doctors, nurses, senior pharmacists and pharmacists have degrees that guarantee their professional competence. Continuing education also ensures developed professional skills and the upkeep of competence in changing circumstances.
Co-operation and undisturbed flow of information between the various professional groups help the patient to adhere to the treatments. Pharmacotherapies will be successful only if the whole healthcare chain is involved. The medicine user must not be left alone.
Guidance of medicine users constitutes integral part of healthcare
However, patients do not know automatically how their prescription medicines should be used.
• The healthcare system and professionals give advice and instructions during the doctors' and nurses' visits.
• Simple tools and guidebooks are available.
• Pharmacy professionals further ensure that their customers use the medicines in the correct way.
• The pharmaceutical companies have the duty to produce understandable, updated and useful information to support the use of their products.
Water-tight routines prevent risk situations
A medication error means an event in pharmacotherapy that might develop into a dangerous situation. It can be a result of something done or left undone, or a consequence of a failure in protection.
There are alarms at every step of the pharmaceutical distribution and integrated care pathway.
• The first step is the pharmaceutical distribution level, wholesalers who ensure that no counterfeit medicines enter the official distribution chain and that the medicines are readily available.
• Through their routine procedures, the pharmacies ensure the correct dispensing of medicines and sufficient patient advising. As an additional service, the pharmacy can provide dosage dispensing to those who have difficulties in taking the medicines correctly. The pharmacies also watch for any unnecessary or even potentially dangerous overlapping medications.
• In hospitals and other inpatient care, the effects of the human factor are minimised through instructions leading to solid routines as well as thorough training.
Improvements through co-operation
In the outlines of the recently published Medicines Policy 2020 document, improved medication safety was defined as responsibility of the Finnish Medicines Agency Fimea. When the co-operation with all healthcare operations works, the integrated care pathway of the patients is ensured.
To maintain a good level of medication safety, a constructive contribution of the pharmaceutical industry is also needed. Future pharmaceutical development must also be safeguarded. We must ensure that all people have access to individually suitable medicine alternatives and that there is easily comprehensible information about medicines and their use.