- Hospitals could improve patient safety and save money by reducing the medications dispensed to patients during their stay, suggests a popular opinion piece in Quartz.
- The proposal is for hospitals to stop patients' home medications when they are admitted, unless any are considered to have such compelling benefits that they outweigh a benefit-risk ratio. A similar evaluation would be made at discharge to determine whether any of the patients' previous prescriptions have a compelling enough reason to be resumed.
- The basis for the argument is that patients often come in on as many as 10 medications, of which many are unnecessary or of only marginal benefit.
Logic may indeed dictate that simplifying drug routines would improve safety; the Institute of Medicine estimates that hospitals make one medication error per patient per day. "Each new medicine creates multiple opportunities for wrong drug errors, wrong dose errors, and so on," the authors write.
However, changing to such a system may not be so simple. As the authors note, continuing the home regimen is the path of least resistance; patients would need to be involved in the decisions; and it would be a challenge to establish a protocol and/or computerized support system that would enable physicians to make quick and and reliable decisions on drugs. Lists would need to be created of drugs to "never stop" or "almost always stop" and they would need to be endorsed by professional medical associations.