Drugs ID'd in Most Older Adult Emergency Hospitalizations

Warfarin, insulin, oral antiplatelets, hypoglycemics implicated in most emergency hospitalizations

27 nov 2011-- Adverse drug events from commonly used medications, including warfarin, insulin, oral antiplatelet agents, and oral hypoglycemic agents, account for the majority of emergency hospitalizations in older adults in the United States, according to a study published in the Nov. 24 issue of the New England Journal of Medicine.

Daniel S. Budnitz, M.D., M.P.H., from the Division of Healthcare Quality Promotion at the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues estimated the frequency and rates of emergency hospitalization after emergency department visits for adverse drug events in adults aged 65 years or older. Adverse event data were collected for 5,077 cases identified from the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project from 2007 to 2009, and were used to assess the contribution of specific medications to hospitalizations.

The investigators identified approximately 99,628 emergency hospitalizations for adverse drug events in older adults each year. Adults aged 80 years or older accounted for 48.1 percent of these hospitalizations, and almost two-thirds of the hospitalizations (65.7 percent) resulted from unintentional overdoses. Sixty-seven percent of the hospitalizations involved four medications or medication classes, alone or in combination: warfarin (33.3 percent), insulin (13.9 percent), oral antiplatelet agents (13.3 percent), and oral hypoglycemic agents (10.7 percent). In 1.2 percent of hospitalizations, high-risk medications were implicated.

"Most emergency hospitalizations for recognized adverse drug events in older adults resulted from a few commonly used medications, and relatively few resulted from medications typically designated as high-risk or inappropriate," the authors write.