Early-Month Rx Fatalities Linked to Overworked Pharmacists

MARCH 01, 2005
Ken Rankin

A beginning-of-the-month upsurge in the average pharmacist's workload may be at least partially responsible for an alarming increase in the nation's rate of drug-related deaths during the first few days of each month, pharmacy researchers warned.

The new study, conducted by researchers at the University of California in La Jolla and the Tufts University School of Medicine in Boston, examined millions of death certificates from 1979 to 2000 and discovered that "some types of fatal medication errors spike by 25% above normal at the beginning of the month."

Unable to explain the rise in drug-related fatalities by controlling for such factors as substance abuse or socioeconomic status, the researchers concluded that the likely cause was overburdened pharmacists faced with a sharp jump in prescription orders when those patients on welfare come to pharmacies for medication when their first-of-the-month checks arrive.

Because "there is an increased pharmacy workload at the beginning of each month, some pharmacists may be unusually prone to error in the filling and labeling of prescriptions and may have less time than usual to explain necessary precautions to their patients,"researchers said in a study published in the January 2005 edition of Pharmacotherapy, the Journal of the American College of Clinical Pharmacy.

To reduce potentially fatal medication errors, the researchers suggested that:

  • Patients "be especially careful to check the accuracy"of prescriptions dispensed early in each month
  • Pharmacies consider increasing prescription department staff levels at the beginning of the month
  • Governments stagger payments to welfare recipients, Social Security beneficiaries, and others on assistance over the entire month

Mr. Rankin is a freelance medical writer.