Bmj Usa: Minerva


BMJ 2003; 327 doi: (Published 19 November 2003) Cite this as: BMJ 2003;327:E178

From BMJ USA 2002;Dec:698

It's easy to blame patients for not taking their medicines as directed, but an extraordinarily high number of medication errors seem to be made by hospital staff too. In 36 institutions in one American study, 19% of doses given were considered “in error.” The most common errors were wrong time (43%), omission (30%), wrong dose (17%), and unauthorized drug (4%). Fortunately only 7% of the errors were judged potential adverse events (Archives of Internal Medicine 2002;162:1897–1903).

Minerva wonders if the long term prognosis for doctors who misuse alcohol is any different from anyone else with the same problem. A 21 year follow up of 100 alcoholic doctors found that 24 had died directly from their alcoholism, 73% considered themselves recovered alcoholics, and 9% had developed oral, throat, or esophageal cancer. Of the 56 who are still alive, 29 have retired and 27 are still working as doctors (Alcoholism 2002;37:370–374).

A tenth of patients with dyspepsia present with alarm symptoms. But although alarm symptoms are said to predict a bad prognosis, a three year prospective study found they gave low positive predictive values and high negative predictive values. The authors say this …

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