CDC study: Four meds sending elderly to hospital emergency rooms

A small group of blood thinners and diabetes medications causes two-thirds of the nearly 100,000 yearly emergency hospitalizations for adverse drug events in older U.S. adults, according to a study by the Centers for Disease Control and Prevention.

The study, published last week in the New England Journal of Medicine, used data collected between 2007 and 2009 from a nationally representative sample of 58 hospitals participating in CDCs National Electronic Injury Surveillance System–Cooperative Adverse Drug Event Surveillance project. Almost half (48.1 percent) of these hospitalizations occur among adults aged 80 years or older, and two–thirds (65.7 percent) of the hospitalizations were due to overdoses, or to situations in which patients may have taken the prescribed amount of medication but the drug had more than the intended effect on the patients body.

Four medications, used alone or together, accounted for two–thirds of the emergency hospitalizations:

· 33 percent, or 33,171 emergency hospitalizations, involved warfarin, a medication used to prevent blood clots.

· 14 percent involved insulin. Insulin injections are used to control blood sugar in people who have diabetes.

· 13 percent involved antiplatelet drugs, such as aspirin or clopidogrel, which prevent platelets, or pieces of blood cells from clumping together to start a clot.

· 11 percent involved diabetes medications that are taken by mouth, called oral hypoglycemic agents.

“These data suggest that focusing safety initiatives on a few medicines that commonly cause serious, measurable harms can improve care for many older Americans,” said Dan Budnitz, M.D., M.P.H., director of CDCs Medication Safety Program. “Blood thinners and diabetes medicines often require blood testing and dosing changes, but these are critical medicines for older adults with certain medical conditions. Doctors and patients should continue to use these medications but remember to work together to safely manage them.”

The study identified specific medication safety issues that provide the greatest opportunities for reducing patient harm and health care utilization today.

CDC scientists noted medications currently identified by national quality measures as being high–risk or potentially inappropriate for older patients were rarely identified as the cause of emergency hospitalizations (1.2 percent and fewer than 6.6 percent, respectively).

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