NLM Director's Comments Transcript
Senior Drug Hospitalizations: 01/03/2012

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Greetings from the National Library of Medicine and MedlinePlus.gov
Regards to all our listeners!
I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.
Here is what's new this week in MedlinePlus.

The two types of diabetes drugs identified in the study were insulin and oral (or by mouth) diabetes medications. The two types of blood thinners identified in the study were warfarin (also known as Coumadin and Jantoven) plus other antiplatelet medications, such as aspirin and Plavix.
Specifically, warfarin was responsible for 33 percent of emergency room visits for adults age 65 and older and antiplatelet drugs were responsible for 13 percent of drug-related emergency hospitalizations. Insulin injections were responsible for 14 percent of emergency hospitalizations and oral hypoglycemic drugs were responsible for 11 percent.
The study found about half of all drug related hospitalizations occurred among seniors age 80 or older. In addition, about two thirds of drug related hospitalizations occurred because of unintended overdoses. The study's four authors explain hospitalizations from an unintended drug overdose often occur in medications where there is little difference between a healthy and unhealthy dose. Unintended drug related overdoses also tend to occur when a medication's dose requires periodic adjustments that are linked to blood tests and when drugs – even in small doses –have a powerful impact.
Overall, the study found most senior, drug related hospitalizations are linked to four types of medications – with little latitude for dose error – among persons who are age 80 and older. Interestingly, the study reports other, pre-identified, high risk medications only accounted for a little more than one percent of senior emergency hospitalizations.
The authors estimate about 100,000 Americans, age 65 or older, are taken to hospitals annually for adverse reactions to medications.
The study was based on data gathered in 58 hospitals nationwide from 2007-2009 by the U.S. Center for Disease Controls and Prevention (CDC)'s Adverse Drug Event Surveillance Project. The overall findings are projected from a large, national sample (not the universe) of reported drug related hospitalizations.
The study's lead author told the New York Times, (and we quote): 'we (the authors) were surprised how many of the emergency hospitalizations were due to such a relatively small number of...drugs' (end of quote).
The authors (who are from the CDC as well as Emory University School of Medicine) add the study identifies specific areas where the management of medications needs to be improved among hospitals, clinics, and health care providers.
The authors write (and we quote): 'our findings suggest that efforts to improve medication safety for older adults should focus on areas in which improvements are most likely to have sizable, clinically significant, and measureable efforts, such as improving the management of antithrombotic and antidiabetic drugs' (end of quote).
Auspiciously, the current study's drug safety implications – plus specific information about blood thinners and diabetes medications – all are well covered within MedlinePlus.gov. For example, MedlinePlus.gov's medication errors health topic page explains you can prevent drug related mistakes by:

knowing your medicines
reading drug labels and following directions
and asking questions such as what are common problems associated with the medication, and if the medicine can be taken with others that already are prescribed for you.

MedlinePlus.gov's medication errors health topic page provides a section of tips tailored for seniors, including a website on using medicines safely from the National Institute on Aging. To find it, just scroll down to the 'seniors' section within MedlinePlus.gov's medication errors health topic page.
A helpful website from Consumers Union adds ten tips to prevent an accidental overdose – and is available in the 'specific conditions' section of MedlinePlus.gov's medication errors health topic page. A useful website from the Joint Commission (also available in the 'specific conditions' section of MedlinePlus.gov's medication errors health topic page) helps you talk to a health care provider about the medications you are taking.
MedlinePlus.gov's medication errors health topic page also contains research summaries, which are available in the 'research' section. Links to the latest pertinent journal research articles are available in the 'journal articles' section.
To find MedlinePlus.gov's medication errors health topic page, type 'drug errors' in the search box on MedlinePlus.gov's home page, then, click on 'medication errors (National Library of Medicine).'
In addition, specific information about diabetes medicines and blood thinner medications are available in the 'diabetes medicines' and 'blood thinners' health topic pages respectively.
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A disclaimer – the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider. I want to take the opportunity to wish you a very happy holiday season and a healthy New Year. The National Library of Medicine and the 'Director's Comments' podcast staff, including Dr. Lindberg, appreciate your interest and company – and we hope to find new ways to serve you in 2012.
I look forward to meeting you here next week.
Two types of diabetes medications and two types of blood thinners (used alone or together) may have been responsible for two thirds of drug-related, senior, emergency hospitalizations from 2007-2009, finds a national study recently published in the New England Journal of Medicine.
NLM Director's Comments Transcript - Senior Drug Hospitalizations