Letters to the Editor 2019

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To the Editor: 

I want to shed light on a public health problem that I am very passionate about - preventable death due to adverse drug reactions and interactions.  

In 2017, I lost my wife, who was taking numerous prescriptions at the time. Several of the drugs not only worsened her conditions due to adverse side effects, but ultimately hastened her death.  

Because I have personally witnessed the devastation that can occur when medications are prescribed with minimal regard for how they affect an individual or interact with one another, I want to help raise awareness in the general public, so that this does not happen to someone else or their loved ones.  

New Jersey's "Rights of Patients" legislation (30:4-24.2, section d) includes the right "to be free from unnecessary and excessive medication" and yet this problem prevails as one of the four leading causes of death in the U.S. This is unfortunate because these deaths are largely preventable.  

With the vast number of medications available today, understanding how they may affect a patient and interact with one another is highly complex. Patients can't be expected to know this information and, instead, rely on their physicians and the medical community to determine if a prescribed drug is safe and appropriate.  

In today's health care climate, doctors are forced to see more patients in a day while spending a greater percentage of their time on administrative tasks. Many facilities also staff fewer nurses, resulting in heavier patient loads.  

These factors lead to a decrease in patient contact, providing less opportunity for physicians and nurses to thoroughly review a patient's health and medication history before moving on to the next patient. The consequence is that patient safety is adversely affected.  

Doctors become administrators who spend less time with patients and an increasingly greater portion of their time frustrated with paperwork and navigating the managed care system.  

Nurses burn out, causing high turnover and further exacerbating the nursing shortage that contributes to heavy caseloads.   

The medical community does their best, but I firmly believe that it is inadequate systems, not bad people, that lead to most medication errors and subsequent death.  

Hospitals and other patient-care facilities need to build reliable, formalized systems that underpin the safety of patients and support health care providers in taking a stepwise approach that includes taking good medication history, understanding which patients are at risk for drug interactions, closely scrutinizing patients who are taking multiple drugs, incorporating a review/consultation mechanism into the normal system and providing ready access to this information for busy medical professionals.  

In my wife's situation, there was a rapid escalation in the number of drugs prescribed over a short period. In some cases, the side effects of one drug led to another one being prescribed to address the issue.  

Sometimes these drugs were prescribed by a physician who was responsible for overseeing the care of hundreds of patients. It is a scenario that makes it impossible to thoughtfully evaluate the individual patient and their changing condition in the manner they deserve.  

Until these shortfalls in the health care system can be addressed, adverse drug reactions and interactions will continue to needlessly claim lives.  

I'd urge anyone facing a health crisis - be it their own or that of a loved one - to remember that doctors, nurses, and health care systems are not infallible.  

Advocate for yourself and your loved ones. Ask questions. Educate yourself. Don't allow yourself to be just a number. Your life or your loved one's life may very well depend on it. 

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