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Medication Errors More Common Than Previously Thought

Many Seniors Take Potentially Inappropriate Medications

MedicationsA significant number of older adults who take multiple drugs may be taking potentially inappropriate medications and experiencing adverse drug reactions as a result of polypharmacy (taking many medications), according to a study presented on May 3 at the American Geriatrics Society's 2007 Annual Scientific Meeting. Further boosting risks of such reactions, many older adults don't use pillboxes correctly, according to a second study presented at the meeting, the premier conference on aging research.

Because older adults are more likely than younger adults to have multiple health problems and to take multiple medications, and because medications can interact, older people run increased risks of taking potentially inappropriate medications, taking medications incorrectly, and having adverse drug reactions.

Researchers conducting the first study questioned 124 older adults who were treated at a hospital Emergency Department (ED) about the medications they took. The researchers used a standard questionnaire developed to evaluate medication use in older people. On average, the adults were taking 8 different medications, the researchers found. More than 30% were taking at least one potentially inappropriate medication that had been prescribed prior to their visit to the ED. Another 6% had been prescribed a potentially inappropriate medication while at the ED. Potential adverse drug events meeting the research criteria were found in 27% of subjects.

Given these findings, screening for potentially inappropriate medication use, as well as a study of predictors of this use, may be warranted, the researchers conclude. "We have taken these findings seriously and are incorporating them into teaching tools at three sites of care for elders: the emergency department, the geriatric assessment clinic, and the nursing home," said Barbara J. Messinger-Rapport, MD, Ph.D., co-presenter and program director for the Geriatric Medicine Fellowship program at the Cleveland Clinic. "We think they will contribute to better patient safety and hopefully to careful medication pruning."

Do Pill Boxes Help Prevent Medication Errors?

In the second study, researchers at Mount Allison University in New Brunswick surveyed 378 older adults, asking about their use of pill boxes and other devices intended to help those who take multiple medications do so appropriately.

Of the 136 adults who completed the surveys, 99 used pill boxes, but few used them as recommended, report the researchers. More than 79% failed to use pill boxes that have multiple compartments for each day's medication—the type that healthcare providers recommend. In addition, about 94% of those who used pill boxes reported that they put their medications in their pill boxes themselves, but rarely or never had anyone else check whether they'd made errors while filling the boxes. In addition, more than 76% of older adults using the boxes said they didn't refer to written directions or medication labels to remind themselves of their medication regimens when filling their boxes.

"Although pill boxes are often recommended and widely used, the types of pill boxes chosen and the ways they are used may not be optimal to ensure adherence," conclude the researchers, Odette Gould and Laura Todd.

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