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Senior Citizen Health & Medicine
Senior Citizens Seven Times More Likely to
Experience Dangerous Drug Errors
Risk More Drug Errors the More Doctors that Treat
Them
 September 14, 2006 - While conventional wisdom
dictates that more doctors are better for your health, a new analysis
released yesterday finds that the more doctors a senior citizen sees,
the greater their risk for dangerous drug errors. Another alarming
finding is that patients over age 65 are the victims of drug errors
seven times more often than younger patients. The average senior faces
an average of 13 potential errors.
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Health & Medicine |
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An analysis of prescription drug alerts, conducted
by Medco Health Solutions, Inc., found that the greater the number of
physicians seen by a patient over age 65, the greater the number of
prescriptions the patient fills, and thus the greater risk for dangerous
drug errors including drug-to-drug interactions, under- or
over-utilization of a drug, duplication of therapies, and incorrect
dosages.
The findings call into question how well different
doctors and specialists caring for patients over 65 exchange information
about the medications they are prescribing, and statistically correlates
a larger care team with a greater risk for preventable medication
errors.
According to the analysis, seniors receiving
prescriptions from two different physicians filled an average of 27
prescriptions in a year, and were at risk for 10 potential prescription
drug errors. However, when the care team consisted of five doctors, the
number of prescriptions filled in one year nearly doubled to 42, and the
number of potential drug errors increased 60 percent to 16.
When seniors received prescriptions from seven
physicians the number of prescriptions increased to 52 and the number of
potential drug errors more than doubled to 22 in one year, compared to
those only seeing two physicians. When the care team reached 10
different physicians, patients filled an average of 66 prescriptions,
and potential errors tripled.
"With more physicians providing care to patients,
more prescriptions are being written -- however, there is clearly a
communication breakdown between prescribers," said Dr. Glen Stettin,
senior vice president, clinical and therapeutic solutions, Medco. "This
analysis illustrates the potentially dangerous and unintended side
effects of an expanded healthcare team -- an issue that is exponentially
more important now that Medicare has opened America's medicine cabinet
to many more older patients."
The analysis reviewed the prescription drug claims
between January and December 2004 of 2.4 million insured adults. The
analysis identified the increased risk of drug errors associated with
the number of physicians a patient sees and the number of pharmacies at
which a patient fills their prescriptions -- a growing trend referred to
as polypharmacy. The analysis compared the potential error rates among
patients 65 years of age and older with the rates of patients under age
65.
Additional findings of the analysis include:
● Patients over age 65 consistently experienced a
drug error rate approximately seven times greater than patients younger
than 65. Seniors faced an average of 13 potential drug errors per
patient, compared to two per patient among those younger than 65.
● One in four seniors (24 percent) received
prescriptions from five or more doctors; one in 20 received
prescriptions from eight or more physicians.
● Among patients 65 and older, those seeing five
physicians filled nearly twice as many prescriptions as those seeing one
physician.
● Nearly one-quarter of the seniors in the
analysis filled their prescriptions at 3 or more pharmacies, with some
seniors using as many as 11 different pharmacies for their
prescriptions.
● Among patients who see five doctors, those 65
and older fill nearly 40 percent more prescriptions than those under the
age of 65.
The implementation of Medicare Part D is expected
to increase the number of seniors with prescription drug coverage and
will likely increase medication utilization, potentially making this
drug safety situation far worse.
A recent PricewaterhouseCoopers report estimates
that Medicare Part D will result in a 20 percent or more increase in
prescription drug utilization by those not currently insured.
"A wider array of physicians and specialists can
improve care for the patient, but it is imperative that the team --
physicians, pharmacists and insurers -- continually exchange information
about what a senior is taking, how much of it is being prescribed, and
for how long," said Dr. Stettin.
Medco's Polypharmacy Safety Program - Filling
the Gaps in the Medication Matrix
To address the risk of the medication matrix, Medco
launched its new Polypharmacy Safety Program. The new program is
designed to reduce the risk of prescription drug errors by identifying
patients receiving prescriptions from multiple physicians and filling
prescriptions at multiple pharmacies, and providing detailed patient
prescription drug history to all prescribers on the patient's care team.
Patients in participating plans are entered into
the safety program automatically by meeting criteria focusing on number
of physicians, pharmacies and number and types of medications. When a
patient meets all criteria, the system generates an alert report for
prescribing physicians with a complete list of the patient's current
prescription drug regimen and history, and the physicians' names and
contact information that are prescribing medications to the patient.
The system was piloted in September 2005 to all
Medco clients enrolled in Medco's RationalMed Patient Safety System. In
a three-month period, RationalMed detected more than 4,600 patients as
having a polypharmacy risk. After notifying the prescribing physicians,
50 percent of the patients realized the benefit of better coordination
of care from the reduction in the number of prescribing physicians
and/or the medications required to continue to treat their conditions.
"By identifying patients that are exposed to
polypharmacy risks and alerting their physicians to this situation,
these risks will hopefully be averted before patients suffer any harm,"
said Dr. Stettin.
About Medco
Medco Health Solutions, Inc. (NYSE:MHS)
is the nation's leading pharmacy benefit manager based on its 2005 total
net revenues of nearly $38 billion. Medco's prescription drug benefit
programs are designed to drive down the cost of pharmacy health care for
private and public employers, health plans, labor unions and government
agencies of all sizes, and for individuals served by the Medicare Part D
Prescription Drug Program. Medco's technologically advanced mail-order
pharmacies and award-winning Internet pharmacy have been recognized for
setting new industry benchmarks for pharmacy dispensing quality. Medco
serves the needs of patients with complex conditions requiring
sophisticated treatment through its specialty pharmacy operation, which
became the nation's largest with the 2005 acquisition of Accredo Health,
Incorporated. Medco is the highest-ranked pharmacy benefit manager on
the 2006 Fortune 500 list. On the Net:
http://www.medco.com/.
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