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Adverse Drug Events in Nursing Homes Are Common

Wed, 08/16/2000 - 12:00am — Karen Stevenson
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More than half of medication-related injuries in nursing homes may have been preventable, according to a Massachusetts nursing home study, titled "Incidence and Preventability of Adverse Drug Events in the Nursing Home Setting." The study was published in the August 1 issue of the American Journal of Medicine, and was conducted by Jerry H. Gurwitz, M.D., of the Meyers Primary Care Institute, a joint initiative of the University of Massachusetts Medical School and the Fallon Healthcare System in Worcester, Massachusetts.

Of the total adverse drug events identified in the study, one was fatal, 6% were life-threatening, 38% were serious and 56% were significant. Psychoactive drugs (antipsychotics, antidepressants, sedatives and hypnotics) and anticoagulants were the most common medications associated with preventable adverse drug events, and lead to oversedation, confusion, hallucinations, delirium, falls and bleeds.

The authors stated that if the study's findings are generalizable, an average-sized U.S. nursing home (106 beds) will have at least 24 adverse drugs events and eight "near misses" per year, and at least 350,000 adverse drug events occur every year, and more than half of those are preventable. The authors consider these estimates to be conservative.

The authors recommend implementation of enhanced surveillance and reporting systems for adverse drug events and medication errors, continued educational efforts relating to optimal use of drug therapies in the frail elderly patient population, and systems-based prevention strategies to prevent ordering and monitoring errors in drug therapy.

More than half of medication-related injuries in nursing homes may have been preventable, according to a Massachusetts nursing home study, titled "Incidence and Preventability of Adverse Drug Events in the Nursing Home Setting." The study was published in the August 1 issue of the American Journal of Medicine, and was conducted by Jerry H. Gurwitz, M.D., of the Meyers Primary Care Institute, a joint initiative of the University of Massachusetts Medical School and the Fallon Healthcare System in Worcester, Massachusetts.

Of the total adverse drug events identified in the study, one was fatal, 6% were life-threatening, 38% were serious and 56% were significant. Psychoactive drugs (antipsychotics, antidepressants, sedatives and hypnotics) and anticoagulants were the most common medications associated with preventable adverse drug events, and lead to oversedation, confusion, hallucinations, delirium, falls and bleeds.

The authors stated that if the study's findings are generalizable, an average-sized U.S. nursing home (106 beds) will have at least 24 adverse drugs events and eight "near misses" per year, and at least 350,000 adverse drug events occur every year, and more than half of those are preventable. The authors consider these estimates to be conservative.

The authors recommend implementation of enhanced surveillance and reporting systems for adverse drug events and medication errors, continued educational efforts relating to optimal use of drug therapies in the frail elderly patient population, and systems-based prevention strategies to prevent ordering and monitoring errors in drug therapy.