Diabetes drugs and blood thinners cause two-thirds of the 99,628 US senior hospitalizations each year because of drug adverse events, researchers from the CDC reported in NEJM (New England Journal of Medicine). The authors added that hundreds of millions of dollars could be saved if focus were placed on education and drug management of patients with certain long-term (chronic) diseases and conditions.
This article comes as the US government aims to bring down the number of repeat hospitalizations by one fifth by the end of 2013.
Dan Budnitz, M.D., M.P.H., director of CDC's Medicaton Safety Program said:
"These data suggest that focusing safety initiatives on a few medicines that commonly cause serious, measurable harms can improve care for many older Americans. 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."
An adverse event is "Any untoward medical occurrence that may present during treatment with a pharmaceutical product but which does not necessarily have a causal relationship with this treatment." [International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use.]"
Budnitz and team gathered information from 58 hospitals around the country between 2007 and 2009. They said their data came from a nationally representative sample; patients involved in the CDC's National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project. Their study did not include emergency hospital visits cause by drug abuse, withdrawal or deliberate self-harm.
48.1% of hospital admittances occurred among patients aged at least 80 years. 65.7% were caused by drug overdoses, or unexpected reactions to medications which were taken according to instructions.
Four medications, used either on their own or in combination, cause two-thirds of emergency hospitalizations:
Warfarin - caused 33% (33.171) of hospitalizations. Warfarin is a blood thinner - it prevents the formation of blood clots. When not monitored properly it can lead to hemorrhaging. The authors believe the cost of warfarin-cause hospitalizations is in the hundreds of millions of dollars annually.
Insulin injections - caused 14% of emergency hospitalizations. Insulin injections are used for blood sugar control in patients with diabetes.
Antiplatelet drugs - caused 13% of emergency hospitalization. Examples include aspirin and clopidogrel. These drugs also help prevent the formation of blood clots (prevent platelet formation)
The authors say that national monitoring of adverse drug events of newly approved medications is vital, especially those that become popular.
The researchers noted that drugs which are currently viewed as high risk for hospitalizations, such as painkillers (acetaminophen), were not causing a very high number of hospitalizations of seniors.
Chief medical officer of the Centers for Medicare & Medicaid Services, Patrick Conway, M.D., M.Sc., said:
"Policies and improvement programs to promote safe use of medications that most commonly cause serious, measurable harms can increase patient safety and reduce unnecessary hospitalizations and costs at the same time.
We are working across the federal government to address common preventable adverse drug events through medication management, care transition programs, and other initiatives."
An elderly person is seven times more likely to be admitted to hospital for an adverse drug event than a younger individual, the authors explained.
Americans are living longer, this means that seniors will represent a higher percentage of the country's population, which also means there will be even more adverse drug events. 12.8% of the US population was aged at least 65 years in 2010, a total of 16,901,232 senior males and 22,571,696 senior females.
Approximately 40% of seniors take between five and nine medications, while 18% are on at least ten drugs, the authors found.
The researchers say that there should be closer liaison between hospitals and primary-care doctors (general practitioners), to make sure that drug use is monitored properly - this would significantly reduce emergency hospitalization numbers. Budnitz said that pharmacists should also become more closely involved.
In an Abstract in the same journal, the authors concluded:
"Improved management of antithrombotic and antidiabetic drugs has the potential to reduce hospitalizations for adverse drug events in older adults."
Putting diabetics on a low carb diet would decrease the need for insultin. Yet we tell them to eat anything they like and then take their drugs. Surely, ignorant doctors and nutritionists bear the blame for forcing high carb/essentially high sugar diets on people with blood glucose regulation problems.
posted by Claude T.Jacquet on 27 Nov 2011 at 9:04 am
I agree 100/100, there is a very poor or no communication between Doctors and patients,especially old patients,some of them,instead of asking you to change your diet,they keep on giving you drugs that have very bad side effects.
It is a big waste,some of the patients,throw them in the garbage and are afraid to tell their Doctors that they are not taking them. Myself, I am a 70 years old diabetic patient from Haiti,I do some research and use my own good judgement,instead of throwing them in the garbage,I just don't use the refills,I know my body more than the Doctors,we have to work together,I use the medications that are really needed,thank you.......Claude
posted by Sergio Balcazar on 27 Nov 2011 at 8:35 am
Does getting old means getting all kind of diseases? I don't think so. People like to live the "normal" life, eating, drinking, smoking, getting fat, and eventually getting the so called "degenerative diseases" that start piling up in their late 30's or early 40's.
When they reach their 60's and have been trusting their doctors and their pills believing that they will take care of their ailments, they come to realize that they are already loaded with complications of the very diseases that they had taken "good" care of.
Now they need more pills with all the side effects that these carry. That is why, about 14 years ago I decided to stop living the "normal life" and start practicing a Prime Time Life. With the "normal" life" you eat the "normal" foods, drink the "normal" drinks, practice the "normal" activities and eventually you get the "normal" diseases, and will die the "normal" death. My advise for those who are aging (45, 50 y.o. and older) is, learn about living a Prime Time Life, and living a Healthy Lifestyle. That way you will not need pills to "treat" or to "manage" any condition. What pills do is to perpetuate and complicate the very medical condition that they are supposed to treat. SB-MD
posted by Chester A Pilcher on 27 Nov 2011 at 8:23 am
I have been on Coumadin and warfarin for 13 years after suffering multiple pulmonary infarctions. my dosage never varied more than +/-2.5mg a week. recently Express Scripts substituted a so-called generic Jantoven even though my prescription said "no substitutions". The pharmacist insists the "no" means they can substitute generics. My PT's have become very erratic. May God help us as these kinds of people make life threatening decisions under Obamacare.
posted by Daniel Haszard on 27 Nov 2011 at 8:22 am
The use of powerful antipsychotic drugs has increased in children as young as three years old. Weight gain, increases in triglyceride levels and associated risks for diabetes and cardiovascular disease. The average weight gain (adults) over the 12 week study period was the highest for Zyprexa—17 pounds. You’d be hard pressed to gain that kind of weight sport-eating your way through the holidays.One in 145 adults died in clinical trials of those taking the antipsychotic drug Zyprexa. This was Lilly's #1 product $5 billion per year sales,moreover Lilly also make billions more on drugs that treat diabetes.
posted by Richard Crespin on 27 Nov 2011 at 8:15 am
I have been diagnosed as a diabetic, however; I have discovered that my body puts out boocoo insulin, yet, my body does not know it is there, so I added chromimum picolinate to my regimen, in doing so it helps my body to recognize the existing insulin. Sincerely Richard.
The expression "Adverse event," caps it all. Looking carefully enough at each drug any senior may be taking would eventually expose harmful effects from ALL -- not just a select few. Most all of these drugs treat symptoms, none are cures. Many were manufactured to treat one disease and then later to treat another disease. This in itself should caution any user as to the actual efficacy of such "wonder drugs." The official "adverse event" is failure of most patients to have neglected their health in the first place. First and foremost YOU are responsible for your health -- whether YOU live a healthy life style.
Once taking a handful of medications the best thing and the most difficult thing for most patients (the drug dependents) is to get moving physically, and to control what they put in their mouths. Instead, most cop out and do the simple and least effective thing -- opening the bottles and popping pills into their over fed mouths.
Some of the most serious adverse effects of the drug cocktail you take once or twice a day are seldom mentioned. This is the side effects caused by most any drug -- the one called drowsiness, lethargy, agitation, emotional turmoil, and increased appetite. Even though the drug companies have to report this with each ad they throw at you, they love this vicious circle they put you in.
You are effectively too engrossed with all of these side effects to exercise or use self control when stuffing your mouth full of carbs and fat. Yet, the fact remains...only YOU can make the best change. And that, my dear souls, is to get moving (no better time than right now) and use portion control at each of three meals.
Do this gradually, following a written down record with goals set for each week. Do these two things every day no matter how difficult and you will begin to see changes that no drug company is going to tell you about. Should you not heed this advice you will be fodder for more and more drugs that the drug companies will be pushing onto your doctor to write a script for you to fill. This makes the drug company billions, it makes a six figure salary for your doctor, and makes most pharmacists far richer than you or me, and makes most nurses and the hospitals they serve some of the biggest incomes in the country. Get moving, but before you do, consult with your doctor before starting any exercise regimen or changing or modifying your diet while taking prescribed drugs.
posted by James Robinson on 27 Nov 2011 at 7:47 am
I am on warfarin and have been hospitalized because of it. The likelihood is much, much smaller with good monitoring. I changed doctors - the second one taught me the importance of it. It is crucial to have a good doctor who explains things properly.
'Thousands Of Seniors Hospitalized Due To Diabetes Drugs And Blood Thinners Annually, USA'
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