Health and Medical News and Resources

General interest items edited by Janice Flahiff

Studies Evaluate Criteria For Detecting Potentially Inappropriate Medications In Older Hospitalized Patients

From the 13 June 2011 Medical News Today article

 Using the Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP) criteria was associated with identification of adverse drug events in older patients, according to a report in the June issue of Archives of Internal Medicine, one of the JAMA/Archives journals. The article is part of the journal’s Less Is More series.

According to information in the article, adverse drug events (ADEs) are a significant issue in the older population, and are thought to represent an important cause of hospitalization and account for substantial health care expenditures. Some ADEs are associated with potentially inappropriate medications (PIMs): agents that may cause problems in older patients “because of the higher risk of intolerance related to adverse pharmacodynamics or pharmacokinetics or drug-disease interactions.” During the last two decades, the Beers criteria for judging whether a medication is appropriate for use in an older patient have become the leading standard. Nevertheless, the authors write, research into whether the Beers criteria are associated with avoidable ADEs has not generated consistent results….

…According to the authors, the results suggest that STOPP criteria were more likely than Beers criteria to reveal ADEs in general, avoidable or potentially avoidable ADEs, and ADEs that may have factored into the patient’s hospitalization. “We believe that this finding strengthens the argument for the use of STOPP criteria in everyday clinical practice as a means of reducing the risk of ADEs in older patient,” they write. …

For suggestions on how to get this article for free or at low cost, click here

June 14, 2011 Posted by | Consumer Health, Consumer Safety, Professional Health Care Resources | , , , | Leave a comment

Doctor’s Office Is Usually First Stop In Medication Mishaps

From the 6 May 2011 Medical News Today article

Harmful effects of medication bring an estimated 4.5 million patients to doctors’ offices and emergency rooms yearly, according to a new study, and people who take multiple medications are particularly vulnerable to unpleasant or dangerous side effects, allergic reactions and toxicity.

Such medication mishaps are a widely recognized problem in health care, but until now, most research has focused on their incidence in the hospital.

“The outpatient setting is where 80 percent of medical care takes place-where we would expect the real burden of the problem to be,” said Urmimala Sarkar, M.D., lead study author, at the University of California, San Francisco.

Analyzing data from 2005 to 2007 from the National Center for Health Statistics, the researchers found that 13.5 million outpatient visits during this three-year period had links to negative effects from prescription medications, in the study appearing online in the journal Health Services Research. …

…While some unwanted effects are inevitable with drug treatment, “many are preventable,” Sarkar said. To reduce their incidence, she said, “medical counseling in doctors’ offices and pharmacies has to be better. Patients need to know what medications they’re on and their possible side effects, and to understand what they’re allergic to.”

Steps to alleviate drug-related problems ultimately should include changes in the health care system, such as coordinated electronic medical records to facilitate information sharing between clinicians, Sarkar said.

Sarkar U, et al. Adverse drug events in U.S. adult ambulatory medical care. Health Services Research online, 2011.

May 6, 2011 Posted by | Consumer Health | , , , , | Leave a comment

Adverse drug events costly to health care system: Vancouver Coastal Health-UBC research

Adverse drug events costly to health care system: Vancouver Coastal Health-UBC research
Emergency department physicians call for screening tools

From the February 25, 2011 Eureka news alert

Patients who suffer an adverse medical event arising from the use or misuse of medications are more costly to the health care system than other emergency department (ED) patients, say physicians and research scientists at Vancouver General Hospital and UBC. Their research, the first to examine the health outcomes and cost of patient care for patients presenting to the ED with adverse drug events, is published today in the Annals of Emergency Medicine.***

The research team, led by Dr. Corinne Hohl, emergency physician at Vancouver General Hospital and research scientist with the Centre for Clinical Epidemiology and Evaluation at Vancouver Coastal Health and the University of British Columbia, studied the health outcomes of patients who had presented to the emergency department with an adverse drug event and compared them to patients who presented for other reasons.

An adverse drug event is an unwanted and unintended medical event related to the use of medications.

After adjustment for baseline differences between patient groups, researchers found no difference in the mortality rate of the patients they studied, but those presenting with an adverse drug event had a 50% greater risk of spending additional days in hospital, as well as a 20 % higher rate of outpatient health care needs. The team followed 1,000 emergency department patients from Vancouver General Hospital for six months.

This new research builds on a 2008 study, published in the Canadian Medical Journal, which showed more than one in nine emergency department visits are due to medication-related problems.

“What we are finding is that these incidents are common and costly, both in terms of patient health and utilization of health care dollars,” says Dr. Corinne Hohl. “We also know that these events are hard for physicians to recognize, and that nearly 70 percent of these incidents are preventable.”

In BC alone, hospital emergency departments treat an estimated 210,000 patients each year for adverse drug events. The most common reasons for them are adverse drug reactions or side effects to medication, non adherence, and the wrong or suboptimal use of medication. The research team estimates that the cost of treating these patients is 90% greater than the cost of treating other patients after adjustment for differences in baseline characteristics. The added cost could be as much as $49 million annually.

The research team has been developing screening tools to better assist health care providers in the emergency department in recognizing patients at high risk for adverse drug events, as well as developing an evaluation platform that will help inform prescribing practices for physicians in the community

“We anticipate the development of a screening tool will be able to increase the recognition rate of these adverse drug events from 60 to over 90 percent, and we will be able to treat the patient effectively and rapidly, improving his or her care,” says Dr. Hohl.

“Right now we spend a lot of time trying to diagnose what is wrong with the patient, yet often miss the fact that there is a medication-related problem. This means that patients often go home still on a medication which may be causing harm.” We are also using the data from this research project to help develop a new drug evaluation platform to inform prescribing practices for physicians in the community. The hope is to prevent many of these adverse events from even taking place.”

###

Funding support for this research is through Vancouver Coastal Health Research Institute, the Michael Smith Foundation for Health Research, and the Department of Surgery at the University of British Columbia.

**Not at Web Site as of this posting

To obtain this article for free or at low cost click here for suggestions

 

Related articles


 

February 25, 2011 Posted by | Medical and Health Research News | , , , | Leave a comment

   

%d bloggers like this: