More Fatal Medication Errors Found at Beginning of Month

The Pharmaceutical Care ManagementAssociation (PCMA) recentlycommented on "A Spike in Fatal Errorsat the Beginning of Each Month." Theindependent analysis was reported inPharmacotherapy (January 2005). Theresearch findings suggested that fatalmedication errors rise by 25% at thebeginning of each month at retailpharmacies.

The findings were based on theexamination of 47 million death certificatesfrom 1979 to 2000. A cause forthe rise in errors is that, "because thereis an increased pharmacy workload atthe beginning of each month, somepharmacists may be unusually proneto error in the filling and labeling ofprescriptions and may have less timethan usual to explain necessary precautionsto their patients," said theinvestigators.

The researchers offered the followingrecommendations to reduce potentiallydeadly medications at retailpharmacies and to save lives:

• When filling prescriptions at thestart of each month, patients"should be especially careful tocheck the accuracy" of the prescription,and "intensified checking"should be practiced by theclinical staff

• Pharmacists who do not alreadyuse this practice "might consider"having more staff at the beginningof each month