Medication-related adverse events tied to ED visits in the elderly

December 31, 2012

Adverse drug events in the elderly can be prevented with appropriate monitoring, according to CDC.

Adverse drug events in the elderly can be prevented with appropriate monitoring, according to CDC.

Adults aged 65 years and older are twice as likely to visit the emergency department (ED) due to an adverse drug event and 7 times more likely to be hospitalized as a result of the visit, according to CDC. It is also estimated that more than 40% of these ED visits are because of a small list of medications. The rate of adverse drug events is likely to continue rising, given the aging US population and the associated increase in medication use for multiple comorbidities in this population.

Literature suggests that a few key medications or classes are responsible for the majority of adverse event-related ED visits. The first group of drugs implicated are those that require laboratory monitoring to assess safety and efficacy. Such medications include warfarin, insulin, seizure medications, and digoxin. Patients are urged to check with their physician about the necessity of laboratory monitoring for their particular medications and to comply with monitoring as closely as possible. Unintentional overdose of analgesics, including opioids, is another common cause of adverse events leading to emergency department visits. Patients should notify their providers of all current medications including over-the-counter medications (OTC), to avoid duplication in therapy. Lastly, antibiotics are also implicated. When they are prescribed, patients should complete the entire course of antibiotics and refrain from “saving some for later.” Patients should also understand that not all infections require antibiotics to treat effectively.

Additional recommendations for patients to help minimize medication-related adverse events include keeping an updated medication list, following instructions for taking medications carefully and using them only as directed, and asking questions about their medicines.

“Patients should be encouraged to become active participants in their healthcare. Taking simple steps like keeping an up-to-date medication list that includes over the-counter and herbal medications can be a tremendous help especially when there are multiple prescribers,” said Diana Sobieraj, PharmD, assistant professor of pharmacy, University of Connecticut School of Pharmacy, Storrs, Conn. “Working together as a team can help to ensure safe medication practices.”