Do You Know the Drugs You're Taking?

In an emergency, doctors had better be able to find out fast if you're on a risky medication.

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The two items on the agenda for today have nothing in common except that both fall under the vast umbrella of safety and quality—safety for the first one, quality for the second.

Safety first. (I couldn't resist.) The medical community has been begging, nagging, and haranguing the public to keep a current list of medications in a wallet or a comparably accessible place. Without such a list, if you wind up unconscious in an emergency room and no one with you knows your medical history, the ER doctors will be flying blind. You don't want that to happen, especially if you're taking a blood thinner or other medication that could put you at risk if other drugs are administered.

Even if you're conscious and alert when you reach the ER, you may not be able to name the drugs you're on, according to a study that will be published in the November issue of the Journal of Internal Medicine. A team of researchers at Northwestern University's school of medicine asked patients receiving medication for high blood pressure who came to several community health clinics which drugs they were taking to treat their hypertension; 40 percent couldn't name a single one. Those who could weren't very accurate—almost half of them supplied names that didn't match up at all with the drugs their medical records showed they were on.

Message clear?

As for quality, as in quality of life (yes, researchers abbreviate it QoL in journals), I'll shortly be sharing with you a number of E-mails I've received in the wake of my September 21 post about transplant patient Amy Silverstein. She got a new heart when she was 25 years old. Nineteen years later, she has written Sick Girl, a book that will be released next Tuesday, about her post-transplant years. An excerpt will appear in print Monday in U.S. News. Her portrayal is not easy to embrace. She's not someone who wakes up counting every new day as a blessing.

Many people who have had or are close to someone who had a transplant reacted strongly. The E-mails I've gotten have been extraordinarily personal, thoughtful, and insightful—and often sympathetic as well. I'm still going through them. When you read the portions of them that I will post, I think you'll be as moved as I've been.

P.S. I'm sorry I've been absent here since September 27, but this year's rankings of managed-care plans, which are one of my responsibilities, are vastly more complicated than the 2006 version. As you'll soon see, we'll extensively break down onscreen the various ways in which plans are judged on performance, and we'll add new measures as well. Last year, for instance, six measures were folded into the diabetes category, but only two were displayed; this year all six will be. More than doubling the onscreen information has devoured many hours, some of which I would rather have spent blogging. Once it's live, I think you'll agree that it was worth a little spreadsheet eyestrain.