The study conducted by University of California, San Diego sociologist David Phillips
is the first to document a beginning-of-the-month spike in deaths attributed to mistakes in prescription drugs.
"Government assistance payments to the old, the sick and the poor are typically received at the beginning of each month. Because of this, there is a beginning-of-the-month spike in purchases of prescription medicines,” Phillips says. "Pharmacy workloads go up and - in line with both evidence and experience - error rates go up as well. Our data suggest that the mortality spike occurs at least partly because of this phenomenon.”
Phillips and his coauthors examined all United States death certificates from 1979 through 2000 to analyse the 131,952 deaths classified as fatal poisoning accidents from drugs. A small number of the deaths were from adverse effects of the right drug in the right dose. The vast majority, 96.8 percent, resulted from medication errors.
The beginning-of-the-month mortality spike was particularly pronounced in people for whom the mistakes proved rapidly fatal - those who were dead on arrival at a hospital, died in the emergency department or as outpatients. In this category, deaths jumped by 25 percent above normal.
Phillips notes that database used in the study did not contain highly specific clinical information - no information on prescription type, dosage, days supply, etc. - and he urges further research with data richer in this kind of detail.
To reduce the medication-error death rate, Phillips suggests that pharmacies consider increasing staffing levels at the beginning of the month and that government officials consider spreading assistance payments out over the entire month.
MEDICA.de; Source: University of California - San Diego