Nearly 100,000 adults aged 65 and older are hospitalized on an emergency basis each year as a result of adverse drug events, according to a recent study
in the New England Journal of Medicine
. Two-thirds of the hospitalizations are due to 4 medications or medication classes, either alone or in combination, including warfarin, antiplatelet drugs, insulin, and oral diabetic agents. “We need to focus on those areas where we can have the greatest potential to reduce hospitalizations and healthcare costs,” stated Daniel S. Budnitz, the study’s lead author and director of the CDC’s medication safety program (CDC Press Release
This study supports something that I have been promoting for a while. Since most community pharmacists don’t seem to have time to actively counsel every patient receiving a prescription, selective counseling may be appropriate. The NEJM
study says that patients aged 65 years and older are hospitalized due to ADR’s primarily from 4 drugs or drug classes (Pharmacy Times
). How would you apply that information to your practice? I would suggest that you selectively counsel older patients getting drugs in these groups, maybe starting with one drugs such as warfarin—and then adding others as you have time. It would seem like focusing on both new and refill prescriptions would be the best monitoring/education strategy. Does this make sense to you?