November 28, 2011 — A recent study published in the New England Journal of Medicine has found that just four drugs cause 67% of all emergency hospitalizations among Americans over 65 years of age — sending nearly 100,000 to the emergency room every year.
The study found the following percentages of hospitalizations for four types of drugs:
- 33% – Warfarin (Coumadin), a blood-thinner
- 14% – Insulin injections
- 13% – Clopidogrel (Plavix) other anti-platelet drugs
- 11% – Oral hypoglycemic diabetes drugs
These drugs are commonly prescribed to older Americans, but they all difficult to use, and accidental overdoses are very common. Warfarin, which causes 33% of hospitalizations, is notoriously difficult to administer, has a narrow margin between therapeutic and toxic doses, and interacts with many types of food. Insulin injections require blood testing and changing doses.
These drugs may also interact with each other, which is a problem because they are so commonly prescribed.
It is interesting to note that relatively few hospitalizations resulted from medications typically designated as “high-risk.” Improving management of anti-thrombotic and anti-diabetic drugs could significantly reduce emergency hospitalizations for older adults.
The findings are the result of a nationally representative sample of 58 hospitals that participated in the Center for Disease Control study of adverse drug events between 2007 and 2009. The 58 hospitals in the study saw 5,077 emergency admissions over the study period, yielding a national estimate of 99,628 per year. Half of those admissions were for adults over 80 years of age, and 65% of admissions were due to unintentional overdoses. Admissions for Warfarin, Insulin injections, and oral hypoglycemic diabetes drugs were nearly all due to unintentional overdosing.
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