CHICAGO March 4
—
Largely because of doctors' errors, older
non-hospitalized Americans suffer about a half-million
preventable drug side effects each year, ranging from
nausea to life-threatening kidney failure, a study
suggests.
About 20 percent of the side effects are caused by
patients' mistakes, said the researchers, who studied
about 30,000 people on Medicare in New England. But most
of the preventable drug reactions result from doctors'
errors.
"It's obvious that it's a major issue, a major
problem," said Dr. Jerry Gurwitz, the lead researcher
and a professor at the University of Massachusetts
Medical School.
The findings appear in Wednesday's Journal of the
American Medical Association.
Previous studies have found similar results in
hospitalized patients, but there is little data on
non-hospitalized patients, the researchers said.
With nearly 40 million Americans on Medicare, the
government's health program for people over 65, the
results suggest that more than 1.9 million drug side
effects about one-fourth of them preventable happen each
year in non-hospitalized elderly people.
About 180,000 of the bad reactions are
life-threatening or fatal, and more than 40 percent of
these may be preventable, the researchers said.
Citing data showing that more than 90 percent of
adults age 65 and older take at least one drug per week,
and about 40 percent use five or more weekly, they said
their figures probably underestimate the problem.
A JAMA editorial said the study helps "provide a
clearer view of the illusion of medication safety."
"Medications still pose a significant risk to
patients ... despite decades of research and advances in
drug therapy," said editorial author Dr. David Classen
of the University of Utah.
Better communication among doctors could help prevent
some bad reactions, Gurwitz said.
Educating patients could also help, said co-author
Dr. David Bates of Boston's Brigham and Women's
Hospital.
"Making sure they understand what they are taking,
why they are taking it, and when they should take it
remains a key component in preventing adverse drug
events in the outpatient setting," Bates said.
Non-preventable reactions included skin rashes in
patients with a previously unknown penicillin allergy.
Preventable ones included bleeding in patients on blood
thinners, blamed on inadequate patient monitoring or
interactions with other drugs.
Heart drugs, diuretics and pain relievers were among
the most commonly implicated drugs.
Some of the problems resulted from drug interactions
and occurred because patients had several prescriptions
from more than one doctor. A computerized system of the
sort used in some hospitals could alert doctors to
outpatients who should avoid a certain drug, Gurwitz
said.
Patients could also help by bringing all their
prescriptions to all doctors' visits, he said.
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