This was successfully posted to your pofile.
This box will close automatically in a few seconds. Close this window
We don't have an e-mail address on file for you. To use AAFP Connection, you must have an e-mail address in our records. Click Here
Common Drugs Most Frequent Culprits in Emergency Hospitalizations
Study Involving Older Adults Points to Need for Better Controls, Guidelines
By Matt Brown
Specifically, the authors estimate that warfarin accounts for 33,171, or 33 percent, of such emergency hospitalizations in older adults, while insulins, oral antiplatelet agents and oral hypoglycemic agents are responsible for another 38 percent. Few hospitalizations -- 1.2 percent -- are thought to result from use of high-risk drugs, and only 6.6 percent are likely attributable to potentially inappropriate drugs.
- Nearly 100,000 emergency hospitalizations due to adverse drug events in older adults occur each year, according to a recent study in the New England Journal of Medicine.
- The study estimates that warfarin, insulins, oral antiplatelet agents and oral hypoglycemic agents are responsible for two-thirds of these hospitalizations.
"The substantial contribution that (antiplatelet agents) make to hospitalizations in older adults is a reminder of the need for careful consideration of risks and benefits for individual patients and counseling about early recognition of hemorrhagic symptoms," say the authors.
AHRQ Offers Medication Reconciliation Toolkit
The free toolkit offers step-by-step instructions and relevant resources for all aspects of building and maintaining a comprehensive reconciliation process. It is based on the MATCH website developed by clinicians at Northwestern Memorial Hospital in Chicago with the support of AHRQ and in collaboration with Northwestern University and The Joint Commission.
"A sound medication reconciliation process must involve all caregiver disciplines, must be integrated into their daily workflow and must have the support of facility leadership to be successful," say the toolkit's authors. "The initial and subsequent improvement work to your medication reconciliation process will ultimately result in improved patient care and patient safety outcomes."
"Make sure patients are not on medications they do not need or that will not really help them, monitor medication use carefully, and instruct patients not to make changes in medications or take new OTC (drugs) without discussing the change with you," he says.
The study also notes that the high number of hypoglycemia-related hospitalizations (an estimated 10,656 each year) suggests that current guidelines and performance measures may not reflect "optimal diabetes management" for all patients.
Again, says Campos-Outcalt, it comes down to knowing the individual patient. Overall, the AAFP does not favor a "strict 'tight' approach" to blood glucose management because it is not appropriate for everyone.
"We are in favor of a flexible approach, depending on patient circumstances," he notes.