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Home Medication Use Sends 700,000 to ER Annually

People over 65 most at risk for adverse reactions to medications, report finds

TUESDAY, Oct. 17, 2006 (HealthDay News) --While many people take their medications without a problem, as many as 700,000 Americans wind up in the emergency room each year because of adverse reactions to drugs they've taken, with 117,000 of those people hospitalized because of reactions.

Those are the conclusions of a new government study published in the Oct. 18 issue of the Journal of the American Medical Association.

"Even lifesaving drugs can be harmful if not taken and monitored properly," said Dr. Daniel Budnitz, a medical officer in the division of health care and quality promotion at the National Center for Infectious Diseases at the U.S. Centers for Disease Control and Prevention.

Medication use is commonplace in America. According to background information in the article, a study done in 2004 found that more than 80 percent of Americans reported using a prescription drug, over-the-counter medication or dietary supplement in the previous week. Thirty percent said they had used five or more drugs in the previous week.

Measuring the incidence of side effects for outpatient drug use has been difficult for several reasons. One is that people don't always report minor side effects to their physicians, and another is that there wasn't a national surveillance system in place to track these events.

Budnitz and his colleagues recruited 63 hospitals that were participating in the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) to participate in the Cooperative Adverse Drug Event Surveillance (CADES). These hospitals are varied in size and in geographic location, and together are considered to be a nationally representative sample.

During the two-year study, the researchers found that 2.5 percent of all ER visits and 6.7 percent of ER visits leading to hospitalization were due to adverse drug events.

More than 21,000 people visited participating hospitals due to adverse drug reactions, during the study period. Using that information, the researchers were able to extrapolate that about 2.4 per 1,000 Americans -- or 701,547 -- visit hospital emergency rooms every year due to problems stemming from their medication use. The researchers estimated that 117,318 people have to be admitted to the hospital each year because of adverse drug reactions.

People over 65 were more than twice as likely to have an adverse drug event as younger people were.

"As many folks 65 and over ended up in the hospital with drug complications as for motor vehicle crashes," said Budnitz.

Some drugs appeared to be more troublesome than others. Generally, these were medications that require careful dosing and periodic monitoring to avoid complications. Insulin, warfarin and digoxin were among those more likely to cause an adverse event, Budnitz said.

Some commonly used medications were often responsible for adverse events. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, caused about 3.3 percent of the adverse drug events, while antihistamines and cold medications were responsible for about 4 percent of the problems.

"There's a strong association between medication use and potential side effects," said Dr. Marc Siegel, an associate professor of medicine at New York University School of Medicine.

Budnitz said that doctors have to educate their patients about their medications and be sure that any necessary follow-up testing and monitoring is done. Both Budnitz and Siegel said it's important for patients to take medications, even over-the-counter (OTC) ones, exactly as directed. Budnitz pointed out that when drugs have been around for a long time, which is the case with many OTC drugs, people tend to be familiar with them and feel they are safe. However, even if you've take a drug in the past without any difficulties, that doesn't necessarily mean you won't have problems with it now because as you age, your body metabolizes drugs differently.

"You should have a healthy concern about your medications, but not an excess worry," said Siegel. "Know the potential side effects and use your medications judiciously, with caution."

More information

To learn more about taking your medications safely, visit the U.S. Agency for Healthcare Research and Quality.

SOURCES: Daniel Budnitz, M.D., M.P.H., medical office, division of health-care and quality promotion, National Center for Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta; Marc Siegel, M.D., internist, New York University Medical Center, associate professor, medicine, New York University School of Medicine, and author, False Alarm: The Truth About the Epidemic of Fear, New York City; Oct. 18, 2006, Journal of the American Medical Association
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