No Longer Accepting CasesN

November 28, 2011 — The New England Journal of Medicine published a new study, which found that just four drugs (blood thinners, diabetes drugs, and anti-platelet drugs) cause two-thirds of emergency room visits for older Americans. These drugs send approximately 100,000 Americans over 65 years of age to the hospital every year.

The study found that the following drugs make up nearly two-thirds of hospitalizations:

  • 33% – Warfarin (Coumadin), a blood-thinner
  • 14% – Insulin injections
  • 13% – Clopidogrel (Plavix) other anti-platelet drugs
  • 11% – Oral hypoglycemic diabetes drugs

The one thing these four drugs have in common is that they are difficult to use, and in combination they may cause life-threatening complications. Although they may have serious interactions, these drugs are some of the most commonly prescribed to older Americans. The drug linked to the most hospitalizations is Warfarin, which accounts for nearly 33% of hospitalizations among older Americans. Warfarin is notoriously difficult to administer, has a narrow margin between therapeutic and toxic doses, and interacts with many types of food.

Diabetes drugs are also difficult to use, because they require blood-testing to determine the appropriate dosage.

The researchers concluded their study with an interesting note: The four drugs that cause most hospitalizations are classified as “low-risk.” Relatively few hospitalizations resulted from medications typically designated as “high-risk. Improving management of anti-thrombotic and anti-diabetic drugs could significantly reduce emergency hospitalizations for older adults.

The study was conducted by the Centers for Disease Control between 2007 and 2009, using a nationally representative sample of 58 hospitals. Over the course of the study, there were 5,077 emergency-room admissions, giving a national estimate of approximately 100,000 per year. 48% of those admissions were people over 80 years of age. 65% of the admissions were due to unintentional overdosing — nearly all overdoses were Warfarin, Insulin injections, and oral hypoglycemic diabetes drugs.