Four medications cause most hospitalizations

Posted in Day to day living Many things I didn't know Safety What is in the Medicine Cabinet on November 25, 2011 by kathy

Blood thinners and diabetes drugs – alone or in combination -  cause the most hospitalizations in older adults. This is a really enlightening report picked up by  New York Times, ‘Well’ editor, Tara Parker Pope.

Aspirin, clopidogrel and other antiplatelet drugs that help prevent blood clotting were involved in 13 percent of emergency visits. And just behind them were diabetes drugs taken by mouth, called oral hypoglycemic agents, which were implicated in 11 percent of hospitalizations.

Two things from the article that struck me:  The medications were all difficult: they require constant monitoring and adjusting.

The other thing that struck me: It’s hard to get it right, and downright dangerous to get it wrong.  It’s very delicate business, making adjustments:

All these drugs are commonly prescribed to older adults, and they can be hard to use correctly. One problem they share is a narrow therapeutic index, meaning the line between an effective dose and a hazardous one is thin. The sheer extent to which they are involved in hospitalizations among older people, though, was not expected, said Dr. Dan Budnitz, an author of the study and director of the Medication Safety Program at the Centers for Disease Control and Prevention.

SafeMedicationUse.ca – The Institute for Safe Medication Practices Canada’s(ISMP-Canada) medication incident reporting and learning system for consumer has further warnings about insulin :

The consumer had recently picked up some boxes of insulin at a pharmacy. Most of the boxes were correct, but one box contained a fast-acting brand of insulin. No one had noticed that the wrong box was mixed in with the other boxes. The consumer reported the incident to ISMP Canada, in the hope of preventing the same mistake from happening again.

SafeMedicationUse.ca has this report on warfarin

The container labelled as “warfarin 1 mg” actually contained warfarin 5 mg tablets, and the container labelled as “warfarin 5 mg” actually contained warfarin 1 mg tablets. This mistake led to the unexpected blood test results. This case is a good example of how a consumer’s awareness and actions helped to avoid harm from an error.

Take away: we consumers have to be increasingly vigilant. For ourselves and our aging parents.

©KathyKastner

Comments (3 Comments)

1. Happy Holidays Greetings to the Sandwich Generation, Caring for Elderly Parents and Babysitting Grandchildren, With An Eldercare Round-up For You | SandwichINK for the Sandwich Generation
   December 8, 2011

   [...] Kathy Kastner at Ability 4 Life for all of us – in AND out of the Sandwich Generation - Four medications cause most hospitalizations for senior citizens. And boy, after you read that, you'll realize we need to be vigilant for our whole family's [...]

2. Lynell
   December 16, 2011

   Thanks for helping me to see tnhigs in a different light.

3. Carolyn Thomas
   December 29, 2011

   Hi Kathy – thanks for the link to the NY Times piece and other helpful (and downright scary) info here.

   Most heart patients taking Plavix are likely being prescribed ‘duel-antiplatelet therapy’ that also includes aspirin: two problem drugs at the same time!

   I was on clopidogrel (Plavix) for a year and a half following my heart attack in 2008 and can confirm that the only reason patients stay on this antiplatelet drug is that we are scared witless of having another heart attack without it, particularly during the first year post-stent. Now many cardiologists are saying “Plavix forever!”

   Like many heart patients on Plavix, I was black and blue with hideously colourful bruises every single day, most of which I had no memory of causing because even the slightest bump or pressure could result in truly spectacular bruising. A simple pedicure or blowing my nose too enthusiastically meant profuse bleeding. Ditto for teeth cleaning at the dentist’s or picking blackberries.

   This article is a timely reminder about the very fine line between meds that can keep us alive and also make life alarmingly challenging at the same time. Thanks Kathy!
   Cheers,
   Carolyn

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