Your parents or grandparents may have gotten their medicine from a local family-owned pharmacy, where the pharmacist knew his customers and their families personally. Most of those pharmacies are gone now, replaced by large chain drugstores. What these behemoth stores lack as far as the personal touch goes, they make up for with other benefits: longer hours, drive-thru pickup for prescriptions, and computerized records that keep track of prescriptions and alert the pharmacist if a customer has been prescribed a drug whose use is contraindicated.
Most people have come to rely on the systems of their doctors and pharmacies to such an extent that they assume that if drug interaction were a possibility, their pharmacist would alert them to it. Unfortunately, this level of faith may be misplaced; a recent investigative series by the Chicago Tribune revealed that pharmacies miss about half of all dangerous drug interactions.
The newspaper tested 255 pharmacies in Chicago and elsewhere in the Midwest and found that different pharmacies, tested repeatedly, missed dangerous interactions from 30-72% of the time. That means that even the pharmacy best at detecting drug interactions missed them about a third of the time. While this study did not take place in Oregon, there is no reason to believe the numbers would be significantly different elsewhere in the country.
Longing for the days of the mom-and-pop pharmacy now? Not so fast. Independent stores had the highest rate of missed interactions, at 72%. But CVS, one of the largest chains, was not far behind, with 63% of potential drug interactions missed.
The U.S. Food and Drug administration cited a study in the Journal of the American Medical Association in estimating that two million people per year in the U.S. experience a serious drug interaction (this included both over-the-counter and prescription meds). About 100,000 of those interactions resulted in the patient's death.
One of the tests referred to in the study involved a common antibiotic and a frequently-prescribed anti-cholesterol drug. Taken separately, these drugs are fine, but together they may cause muscle tissue to break down, and lead to kidney failure and death. The potential interaction should have been fairly obvious to a pharmacist filling these prescriptions at the same time, but often patients receive and fill prescriptions at different times, making it even more likely that a potential interaction would be missed.
In an ideal world, when a pharmacist puts prescription information into his computer, there would be some sort of prominent alert if two of the patient's drugs risked a dangerous interaction. In the real world, this doesn't happen, and pharmacists are often faced with a line of customers, many of whom feel unwell, and all of whom don't want to linger in the pharmacy any longer than necessary. So when the pharmacist or pharmacy tech says, "Do you have any questions?" many people say "no," take their prescriptions, and go.
Pharmacies do provide leaflets with each prescription that discuss intended use, possible side effects, and more. But many people throw these out even before they leave the pharmacy.
Perhaps the biggest cause of pharmacies failing to warn customers of potential drug interactions is that their corporate headquarters require a level of efficiency that may cause them to rush through transactions and miss potential drug interactions. While customers surely appreciate speedy service, few value efficiency at the cost of their lives or health.
If you have not yet suffered a dangerous drug interaction, you may be able to avoid one simply by asking your pharmacist or pharmacy tech, "Does this drug interact with any of my other medicines?" But if you, like most people, failed to do that, and took medicines that had a harmful interaction, you may have some legal recourse. Depending on the circumstances, your prescribing doctor or your pharmacy may be liable for the harm you experienced. Contact an experienced Oregon medical malpractice attorney to learn whether you have a viable claim and to discuss your options.
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