Seniors’ ER Visits for Medication Overdosage

When we’re prescribed a new medication, we usually spend a little time reading the package insert. The list of possible side effects is often daunting – almost enough to persuade us to abandon the medication.  But after a few days (or maybe weeks) the risks of medication are forgotten.  It’s alarming to hear, therefore, that there are almost 100,000 emergency hospitalizations of patients over 65 annually for adverse drug events; nearly half of these are among people 80 years old or older.  This finding comes from a study done by the Centers for Disease Control and Prevention (the CDC) and published in the New England Journal of Medicine.

The data for the study came from 58 US hospitals between 2007 and 2009.  About 2/3 of hospitalizations of people over 65 were caused by drug overdose, or situations where the dosage was correct but the drug behaved differently in these subjects.  A major surprise was the finding that 2/3 of the emergency hospitalizations were due to 4 medications: warfarin, an anti-platelet agent (aspirin or clopidogrel/Plavix®), or an antidiabetic agent (e.g. insulin, metformin, glyburide, rosiglitazone).  The relative percentages for each 4 were 33%, 14%, 13%, and 11%. 

The surprise lay in the fact that drugs considered as being at high risk of overdose or as unsuitable for older patients were seldom identified as causing hospitalization; they comprised only 1.2% and 6.6% of such hospitalization, respectively, compared with the percentages above for the 4 major culprits.

What this means is that people taking drugs to prevent blood clots as well as diabetics on insulin or an oral anti-diabetic have to be particularly careful about the doses of the drugs they take, and be aware of the signs of an overdose.  In many cases, this advice will apply to the older person’s caregiver (spouse, child, friend, or professional caregiver).  At all events, these hospitalizations can, and should, be avoided.