Massachusetts coalition creates tracking form for patients' medications

A new statewide initiative in Massachusetts is intended to stem the tide of drug mishaps by encouraging the state's physicians and patients to get on the same page with an extensive medication list document.

Though med lists aren't new, the comprehensiveness of Massachusetts' "Med List" and the extent of the state's push to get everyone using it appear to be a first.

The list is aimed at giving doctors and patients a standardized, simple way to track a patient's list of prescription and over-the-counter medications, medical conditions, allergies, prescribing physicians, discontinued drugs and more.

The "Med List," produced by the Massachusetts Coalition for the Prevention of Medical Errors, is available for download at the group's Web site (link).

The form can be completed and shared electronically or printed out for patients to complete by hand. The coalition wants physicians to ask patients to fill out the list, adjust it when things change and bring it to every appointment so the information is shared with physicians and other health care professionals.

While this sort of paper-based effort falls far short of the electronic solution experts believe is necessary to greatly reduce medication errors, Massachusetts' list is "a heck of a starting point," said Matt Grissinger, a medication safety analyst at the Institute for Safe Medication Practices. Perhaps the biggest benefit of the effort, he added, is to get patients more involved in their own care.

"How many patients do physicians see where they don't even know what they're taking?" Grissinger said "They'll say, 'I'm taking the pink one for cholesterol and the white one for angina.' This will make it easier for doctors in terms of taking care of the patient."

The coalition, which includes physician, nurse, hospital, employer, consumer and government groups as members, developed the initiative in partnership with the Massachusetts Medical Society and $80,000 from the Commonwealth of Massachusetts Betsy Lehman Center for Patient Safety and Medical Error Reduction.

"The distinguishing characteristic of the 'Med List' is that it can be an important tool for both patient and provider in reducing errors," Kenneth R. Peelle, MD, president of the Massachusetts Medical Society, said in a statement. "It allows the patient to be more involved and more of a partner in his or her health care, and it can facilitate and improve communication between patient and provider -- a critical element in improving health care and patient safety."

A July Institute of Medicine report estimated that more than a half-million preventable drug-related injuries occur among the nation's Medicare patients in the community setting every year.

Using a medication list "is something that everybody should be doing anyhow," said Bruce Karlin, MD, a Worcester, Mass., internist who helped pilot the "Med List" before it went public. "This is true, true quality assurance at its very best."

The expectation is that keeping closer tabs on medications will help address some of the miscommunications between patients, primary care physicians, specialists, hospitals and pharmacies that can lead to medication mishaps.

Albert W. Wu, MD, a Baltimore internist, said that only about a third of his patients have presented a medication list for him to reconcile with his own records to check for potential interactions.

"There have been cases where the patient was still taking a medicine I thought they had discontinued, or a medicine has been added that I was not aware of. The frequency of problems and miscommunications that surface every time you [reconcile using a med list] make it evident that this is something worth devoting time to," said Dr. Wu, professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health and a member of the IOM drug errors panel that wrote the July report.