Don’t Mess with your Meds: Use “STAR Check” to Prevent Errors

Sticking to a drug regimen can be confusing for anyone: Doubly so for anyone with impaired memory or attention deficits. Most stroke patients fall into that category. I know I do.

I left the hospital after my stroke still dazed, groping through each day behind a veil of confusion. Within a few weeks, doctors found that my stroke had been caused by a serious autoimmune clotting disorder, Antiphospholipid Syndrome (APS). Because the danger of repeat strokes is so high with APS, I was “sentenced” to take Coumadin (the generic name is warfarin) for the rest of my life. The Coumadin would make my blood less prone to clots. But too much Coumadin could result in a dangerous bleeding accident.

“It’s very important that you take it exactly as ordered,” my doctor told me.  “You must take it every day. Pick a time when you won’t forget.”

My chest tightened. I couldn’t remember how to spell my name.  How was this going to work?”

I’d also need to take Palquenil (generic hydrocholoroquinine), a drug used to treat autoimmune diseases like lupus and APS.

Coumadin can be complicated. It’s not always possible to find a regimen that allows for the same dose every day. I fretted about making a mistake, and with good reason. Even small dosage errors could prove calamitous.

I needed help. My husband, Jack, suggested  “STAR Check,” a wonderfully simple system used by some of his clients to help prevent errors in “safety-significant” operations. I figured that managing the meds I need to prevet another stroke is about as safety-significant as it gets for me, so I decided to give STAR a try.

The acronym STAR stands for: “Stop.Think.Act.Rview.”

Here’s how I use the STAR system to prevent medication dosing errors:

1.  Stop. Quit what I’m doing. Quiet the mind chatter. Focus on the single task: taking my medicine.

2.  Think. What day it is? “Wednesday.” What’s my Wednesday dose? “5 milligrams. One peach colored pill.” I repeat the process for any other medicines, taking the pills from the bottle and placing them on the counter.

3.  Act. Take the pills, mindfully. I repeat the name as I take them. Coumadin, √. Plaquenil, √ .

4.  Review. Replace the bottles in the drawer or cabinet, repeating the name. Coumadin. Plaquenil.

Then, I go to enjoy my day knowing I’m not likely to end up in a sweat wondering, “Oh, did I take my Coumadin? Or not?”

Other Resources:

“Blood Thinner Pills, Your Guide to Using Them Safely,” US Department of Health and Human Services