Plain Language: Improving Communications from the Federal Government to the Public


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Drug name confusion: preventing medication errors

Carol Rados
From the July-August 2005 issue of FDA Consumer magazine

An 8-year-old died, it was suspected, after receiving methadone instead of methylphenidate, a drug used to treat attention deficit disorders. A 19-year-old man showed signs of potentially fatal complications after he was given clozapine instead of olanzapine, two drugs used to treat schizophrenia. And a 50-year-old woman was hospitalized after taking Flomax, used to treat the symptoms of an enlarged prostate, instead of Volmax, used to relieve bronchospasm.

In each of these cases reported to the Food and Drug Administration, the names of the dispensed drugs looked or sounded like those that were prescribed. There have been others: Serzone, an antidepressant, for Seroquel, used to treat schizophrenia, and iodine for Lodine, a non-steroidal anti-inflammatory drug.

Adverse events that can occur when drugs are dispensed as the wrong medications underscore the need for clear interpretation and better communication between the doctors who write prescriptions and the pharmacists who fill them. The FDA says that about 10 percent of all medication errors reported result from drug name confusion.

&lqt;These errors are not usually due to incompetence,&lqt; says Carol A. Holquist, R.Ph., director of the Division of Medication Errors and Technical Support in the FDA's Office of Drug Safety. &lqt;But they are so underreported because people are afraid of the blame.&lqt; Errors occur at all levels of the medication-use system, from prescribing to dispensing, Holquist says, which is why those people who receive the prescriptions must take action, too. &lqt;Everybody has a role in minimizing medication errors,&lqt; she says.

Medication errors can occur between brand names, generic names, and brand-to-generic names like Toradol and tramadol. But sometimes, medication errors involve more than just name similarities. Abbreviations, acronyms, dose designations, and other symbols used in medication prescribing also have the potential for causing problems.

For example, the abbreviation &lqt;D/C&lqt; means both &lqt;discharge&lqt; and &lqt;discontinue.&lqt; The National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) notes that patients' medications have been stopped prematurely when D/C--intended to mean discharge--was misinterpreted as discontinue because it was followed by a list of drugs.

Illegible handwriting, unfamiliarity with drug names, newly available products, similar packaging or labeling, and incorrect selection of a similar name from a computerized product list, all compound the problem. And, although some drug names and symbols may not necessarily sound alike or look alike, they could cause confusion in prescribing errors when handwritten or communicated verbally, according to the United States Pharmacopeia (USP).

For example, Holquist says that several errors have occurred involving mix-ups with the oral diabetes drug Avandia and the anticoagulant Coumadin. Although they don't look similar when typed or printed, the names have been confused with each other when poorly written in cursive. The first &lqt;A&lqt; in Avandia, if not fully formed, can look like a &lqt;C,&lqt; and the final &lqt;a&lqt; has appeared to be an &lqt;n.&lqt; ...

From: www.fda.gov/fdac/features/2005/405_confusion.html


Writing that's short, sweet linked to jobs, promotions

July 31, 2005
John Eckberg
The Enquirer, Cincinnati

The ability to write well is increasingly becoming an express ticket to a decent job.

A 2004 report from a questionnaire to 120 human-resources employees at corporations that employ 8 million workers concludes that workplace writing is a &lqt;threshold&lqt; skill for hiring and promoting salaried employees.

That means if you can't write with aplomb, even verve, you won't get past the threshold of the front door and certainly won't make it to the corner office.

Produced in conjunction with 120 human resources representatives of companies in the Business Roundtable, which includes giants such as Procter & Gamble, General Electric, Sara Lee and Western & Southern Financial Group, the study found that writing ability is woefully lacking in corporate America. ...

None of this surprises Thomas Clark, a professor at Williams College of Business at Xavier University in Cincinnati.

Clark teaches a communications class - a one-day, one-page memo seminar - for Procter & Gamble interns and new employees.

After 23 years and more than 1,000 workshops, Clark says that his message has not changed much: Clear writing means brevity. Get to who, what, why and when right away. ...

Clark has no doubt: &lqt;Crisp, everyday communication is a competitive advantage.&lqt;

From: news.enquirer.com/apps/pbcs.dll/article?AID=/20050731/COL08/507310306external link icon
Note: Article may no longer be available, or you may have to register or pay to read it.


State report puts high premium on writing skills

July 05, 2005
News release
National Commission on Writing

Despite the high value that state employers put on writing skills, a significant number of their employees do not meet states' expectations. Providing writing training costs taxpayers nearly a quarter of a billion dollars annually, according to an estimate based on a survey released here today by the National Commission on Writing.

The report, Writing: A Powerful Message from State Government (.pdf/535K), concludes that writing is considered an even more important job requirement for the states' nearly 2.7 million employees than it is for the private-sector employees studied in the Commission's previous survey of leading U.S. businesses. State agencies were more likely to consider writing skills in hiring and promotion, and to require writing samples from applicants. The report was issued today by the National Commission on Writing for America's Families, Schools, and Colleges, based on a National Governors Association survey of state human resources directors. Forty-nine of 50 state human resources offices responded to the survey.

&lqt;Clear communication is an essential government function in a democratic society,&lqt; said Bob Kerrey, president of New School University in New York, former governor and senator from Nebraska, and chair of the Commission. &lqt;Because writing is how agencies communicate with each other and their constituents, all of us have a stake in the clarity and accuracy of government writing,&lqt; he said.

The report follows a similar analysis of writing in corporate America released last year by the Commission, which found that while advanced technology in the workplace is requiring employees to write more than ever, many college graduates don't have the writing skills they need. Writing: A Ticket to Work ... Or a Ticket Out (September 2004) surveyed members of the Business Roundtable, an association of chief executive officers from U.S. corporations. ...

Full Story: www.writingcommission.org/pr/message-from-state.htmlexternal link icon
Note: Article may no longer be available, or you may have to register or pay to read it.


Web site will explain medical studies in plain language

June 15, 2005
Laura Landro
The Wall Street Journal

The Wall Street Journal on Wednesday examined patientINFORM, a Web site that will offer free access to medical journal articles on cancer, heart disease and diabetes and &lqt;plain-language explanations&lqt; of the studies' implications for patients. The project is a collaboration by the American Cancer Society, the American Diabetes Association and the American Heart Association. Each month, the groups will review hundreds of published studies from more than two dozen journals, and experts will then translate the studies into lay language for consumers, including explanations of the studies' meaning, how they compare to current knowledge on the issue and how patients should use them in making treatment decisions. According to the Journal, the project comes as &lqt;pressure continues to mount&lqt; for medical journals to provide the public with better access to research. Christine Laine, senior deputy editor of the Annals of Internal Medicine, said, &lqt;We need to show how a particular study integrates into a greater body of evidence, and medical journals haven't done a very good job of doing that.&lqt; The site, which currently is in a pilot phase, next month will begin posting content on studies.

From: kaisernetwork.orgexternal link icon



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