Drug reactions send 700,000 yearly to ER in US

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Drug reactions send 700,000 yearly to ER in US

 

By Lindsey Tanner AP Medical Writer

The Associated Press

The Houston Chronicle

Tuesday, October 17, 2006

 

Chicago - Harmful reactions to some of the most widely

used medicines - from insulin to a common antibiotic

-sent more than 700,000 Americans to emergency rooms

each year, landmark government research shows.

 

Accidental overdoses and allergic reactions to

prescription drugs were the most frequent cause of

serious illnesses, according to the study, the first

to reveal the nationwide scope of the problem. People

over 65 faced the greatest risks.

 

" This is an important study because it reinforces the

really substantial risks that there are in everyday

use of drugs, " said patient safety specialist Bruce

Lambert, a professor at the University of Illinois at

Chicago's college of pharmacy.

 

Even so, the study authors and other experts agreed

that the 700,000 estimate was conservative because bad

drug reactions are likely often misdiagnosed.

 

The study found that a small group of pharmaceutical

warhorses were most commonly implicated, including

insulin for diabetes; warfarin for clotting problems;

and amoxicillin, a penicillin-like antibiotic used for

all kinds of infections.

 

" These are old drugs which are known to be extremely

effective. We could not and would not want to live

without them. But you've got to get the dose exactly

right. Variations, especially on the high side, are

really dangerous, " Lambert said. He was not involved

in the research.

 

Those aged 65 and older faced more than double the

risk of requiring emergency room treatment and were

nearly seven times more likely to be admitted to the

hospital than younger patients.

 

The results, from 2004-05, represent the first two

years of data from a national surveillance project on

outpatient drug safety. The project was developed by

the federal Centers for Disease Control and

Prevention, the Food and Drug Administration and the

U.S. Consumer Product Safety Commission. The study was

published in Wednesday's Journal of the American

Medical Association.

 

The database included 63 nationally representative

hospitals that reported 21,298 bad drug reactions

among U.S. adults and children treated in emergency

rooms during the two-year period. The tally is based

on what emergency room doctors said were complications

from using prescription drugs, over-the-counter

medicines, dietary supplements or herbal treatments.

 

The researchers said it translates to 701,547

complications nationwide each year.

 

" Experts had thought that severe outpatient drug

events were common, but no one really had good

numbers " until now, said lead author Dr. Daniel

Budnitz, a CDC researcher.

 

Complications included diabetics on insulin passing

out from low-blood sugar, excessive bleeding in

patients on warfarin, and severe skin rashes in

patients taking amoxicillin. Drug reactions were

severe enough to require hospitalization in about 17

percent of patients. The study did not include

information on whether any of the reactions were

fatal.

 

" The numbers are quite troubling, " said Jim Conway,

senior vice president at the Institute for Healthcare

Improvement. The tally underscores that " there is a

tremendous number of consumers in the United States

taking medication. "

 

The CDC has estimated that about 130 million Americans

use prescribed medication every month. U.S. consumers

buy far more medicine per person than anywhere else in

the world.

 

Yet a recent study found that doctors' conversations

with patients when prescribing new drugs aren't very

thorough and that side effects often aren't mentioned.

Many of the drugs implicated in the new study require

frequent physician monitoring to make sure the dose is

correct.

 

The new findings highlight the need for better

doctor-patient communication about use of medicines,

Conway said.

 

The number likely underestimates the number of people

who have bad drug reactions outside a hospital setting

because many don't get ER treatment, while others who

do may have symptoms that are mistakenly attributed to

something else, said patient safety expert Dr. David

Bates, a professor at Harvard Medical School.

 

Still, Bates called the effort a significant

contribution since previous reports on the problem

have not been national in scope.

 

- - -

 

On the Net:

 

JAMA: http://jama.ama-assn.org

CDC: http://www.cdc.gov

 

More at:

http://www.chron.com/disp/story.mpl/ap/health/4267195.html

 

 

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