Preventable drug reactions land vets in hospitals

NEW YORK Fri Dec 23, 2011 3:24pm EST

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NEW YORK (Reuters Health) - Unexpected drug reactions land thousands of older veterans in hospitals every year, but a new study suggests many of those hospital stays could be prevented.

Looking at a sample of 678 veterans over age 65 admitted to hospitals under the care of Veterans Affairs (VA) between October 2003 and 2006, researchers estimated that 10 percent of the group's unplanned hospital stays were due to an unexpected drug reaction. Of those, almost 37 percent might have been prevented.

Lead author Zachary Marcum, of the University of Pittsburgh's Division of Geriatric Medicine, told Reuters Health that the new findings will help those involved in ordering, dispensing and overseeing medicine to prevent unneeded and costly hospitalizations.

Estimating that 8,000 hospital stays could have been prevented throughout the VA's system, the researchers determined the unexpected drug reactions cost the VA over $110 million during the study period.

As for what caused the reactions, they found that more than half were due to patients not being prescribed the proper drugs. Another 30 percent of reactions were caused by the patient not following instructions, and 10 percent were attributed to a failure to monitor the patient's use of the drugs.

No link was seen between unexpected reactions and patient characteristics like age, sex or race. Researchers did find, however, that the number of drugs a person takes is tied to the risk of a reaction.

"Anytime you have more medications you have a greater chance of one of them being inappropriate," Marcum said.

About 45 percent of the veterans in the sample took nine or more medications, and about 35 percent took between five and eight.

Dr. Lucian Leape, professor in the Department of Health Policy and Management at the Harvard School of Public Health, said doctors can reduce unexpected reactions by minimizing the use of drugs and by getting patients better informed about what they're taking.

"The most important thing the patient can do is understand why they're taking (the drugs), get the information about them one way or another to head off drug reactions," said Leape. "There's no substitute for the patient being informed."

There needs to be clear and consistent communication between a patient and doctor in geriatric medicine, Marcum added. "I really think that's key."

SOURCE: bit.ly/vyMexf Journal of the American Geriatrics Society, Online December 8, 2011.

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