ISSUE: Medication errors are the single most common type of adverse event. The Institute for Safe Medication Practices reported in 2002 that one out of every 20 prescriptions filled in a pharmacy has an error. While many hospitals and pharmacies are trying to reduce the prevalence of medication errors in a variety of ways, consumers must take an active role in protecting themselves from potential errors of this kind. Therefore, we evaluated how actively involved consumers are in protecting themselves against medication errors by observing their behavior when picking up prescriptions. PROJECT: Observed all individuals who came to pick up a prescription at a specific selection of pharmacies in and around an urban academic institution. By blending into the waiting area, we noted a selection of characteristics about each consumer including: gender, age, race, whether the consumer looked in his medicine bag during the time in which he was visible to us, whether the consumer asked questions of the pharmacist, whether the pharmacist asked the consumer if he had any questions, and whether there were any other significant, distinguishing characteristics about each interaction. RESULTS: The sample size for this study consisted of 220 observed interactions. Fourteen percent (14%) of observed consumers looked in their medicine bags before leaving the pharmacy, and 18% of observed consumers asked medication questions of their pharmacist. Some pharmacists were better than others about actively asking consumers if they had any questions about their medication. Overall, 23% of observed pharmacists asked the consumers if they had any questions about their medication. Other factors such as workload and the number of other pharmacists available influenced whether or not the pharmacists engaged with the consumers and whether or not the consumers had a chance to ask questions. LESSONS LEARNED: The majority of observed consumers did not play an active role in preventing medication errors, suggesting a need for a new, more active protocol to get the average consumer more interested in their own healthcare. A simple reminder poster or card on the counter where the interaction between the pharmacist and consumer takes place may decrease medication errors. ISSUE: Medication errors are the single most common type of adverse event. The Institute for Safe Medication Practices reported in 2002 that one out of every 20 prescriptions filled in a pharmacy has an error. While many hospitals and pharmacies are trying to reduce the prevalence of medication errors in a variety of ways, consumers must take an active role in protecting themselves from potential errors of this kind. Therefore, we evaluated how actively involved consumers are in protecting themselves against medication errors by observing their behavior when picking up prescriptions. PROJECT: Observed all individuals who came to pick up a prescription at a specific selection of pharmacies in and around an urban academic institution. By blending into the waiting area, we noted a selection of characteristics about each consumer including: gender, age, race, whether the consumer looked in his medicine bag during the time in which he was visible to us, whether the consumer asked questions of the pharmacist, whether the pharmacist asked the consumer if he had any questions, and whether there were any other significant, distinguishing characteristics about each interaction. RESULTS: The sample size for this study consisted of 220 observed interactions. Fourteen percent (14%) of observed consumers looked in their medicine bags before leaving the pharmacy, and 18% of observed consumers asked medication questions of their pharmacist. Some pharmacists were better than others about actively asking consumers if they had any questions about their medication. Overall, 23% of observed pharmacists asked the consumers if they had any questions about their medication. Other factors such as workload and the number of other pharmacists available influenced whether or not the pharmacists engaged with the consumers and whether or not the consumers had a chance to ask questions. LESSONS LEARNED: The majority of observed consumers did not play an active role in preventing medication errors, suggesting a need for a new, more active protocol to get the average consumer more interested in their own healthcare. A simple reminder poster or card on the counter where the interaction between the pharmacist and consumer takes place may decrease medication errors.

The 230-kD bullous pemphigoid antigen is a hemidesmosomal protein of the cutaneous basement membrane zone. We have previously cloned overlapping cDNAs corresponding to the human 230-kD bullous pemphigoid antigen gene (BPAG1), located at the human chromosomal locus 6p11-12. Utilizing the cDNA clones, a genomic DNA lambda FIX II phage library was screened. Seven over-lapping genomic clones, spanning approximately 20 kb, were isolated. These clones were shown to contain the entire approximately 9-kb coding sequence of BPAG1, and it consisted of 22 separate exons which varied from 78 to 2,810 bp in size. Elucidation of 2.6 kb of 5'-flanking DNA was found to contain several putative transcriptional response elements, and development of promoter chloramphenicol acetyltransferase (CAT) reporter gene constructs allowed identification of putative cis-elements which confer keratinocyte-specific expression to the gene. In particular, a putative AP2-binding sequence (KRE2) in the position -(1,786-1778) was shown to be responsible for marked enhancement of the endogenous promoter, as well as of a heterologous thymidine kinase/CAT construct, activity in normal human keratinocytes. Normal human keratinocyte nuclear extracts contained a protein, designated as KTP1, which complexed with the KRE2 oligomer by gel mobility shift assays. UV cross-linking and Southwestern analysis suggested that KTP1 is a DNA-binding protein clearly distinct from AP2, and this protein may be responsible for the basal keratinocyte-specific expression of the BPAG1 gene.