Sorting it out

Rainier Ehrhardt/Staff
Dr. Kent Guion, a Medical College of Georgia researcher, has worked out a way to help patients use their drugs safely.

Tiny print on pill bottles can be more than difficult to read. It can be dangerous.


With more than a million estimated drug errors a year, physicians and scientific advisory groups are calling for changes to the way drugs are dispensed in the United States. A Medical College of Georgia researcher said he might have a way to help.

Dr. Kent Guion is creating software to help pharmacists educate patients and help patients track what they are taking. Tentatively called Rx Planner, Dr. Guion's system would supply patients with a calendar that includes easy-to-read information, such as the name and a picture of the medication, an alert if they are taking a drug that looks similar, and picture cues to help them take the drugs the right way.

If the medication is supposed to be taken with water in the morning, for example, a glass of water appears next to the box to check off after taking that dose.

The inspiration came about two years ago when Dr. Guion's mother was having trouble controlling her asthma.

"So, of course I asked the question, 'What are you taking and how?' And the bag of six or seven (medications) kind of got dumped," he said. "And we tried to figure out what to take when.

"I thought if there was a calendar of some sort where we could put pictures to jog your memory, you'd be much, much more likely to follow it accordingly," he said.

Dr. Guion is working with a North Carolina pharmacy to get feedback on his prototype. He also is going through the processes of patenting his idea and trademarking the name.

"It's really an interface between the customer and the pharmacist itself," he said. "If everything goes well, it will help both sides of the situation."

The Institute of Medicine in July estimated there were 1.5 million "adverse drug events" a year because patients took the wrong medication or didn't take it as prescribed, although "the true number may be much higher," the report stated.

The group, which advises the country on health care issues, called for patient education, including better written information provided by pharmacies. It also called for greater communication and partnership among patients, physicians and pharmacists.

Patients taking more responsibility for their drug safety makes sense to Shawn Becker, the director of patient safety at U.S. Pharmacopeia, which sets the standards for prescription and nonprescription drugs and tracks errors.

"One of the problems is people are sort of afraid to ask questions," she said. "You'll take a prescription to the pharmacist, and it's filled by someone behind the counter, you don't really see the pharmacist, you don't ask a question.

"You go and pay for your medication, you take it home and you start to take it according to what's on the label. I don't think people pay a lot of attention to, 'Is this really what the physician told me?'"

Being handed more literature might not solve the problem, either, because people just won't read it, she said.

Still, "Anything that would help the patient to get the right information, to make sure they get the right drug, is certainly beneficial," Ms. Becker said.

Reach Tom Corwin at (706) 823-3213 or


In its July report, Preventing Medication Errors, the Institute of Medicine offered a number of tips to help patients prevent medication errors:

- Make a list of all drugs you're taking, prescription and nonprescription, and any supplements or vitamins. Take the list with you to the doctor.

- Ask that the prescriber write out the name, dosage and instructions for how to take it before you leave the office. Ask about side effects.

- Double-check that the drug and the instructions for how to take it match what the prescriber told you.

- If you are confused or unsure, ask the pharmacist for counseling on the medication or to review a list of your medications.

Source: Committee on Identifying and Preventing Medication Errors, Institute of Medicine



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