Medication Errors Plague Heart Patients, Study Finds

Medication errors are harming heart patients, according to a new study from the Vanderbilt University School of Medicine in Nashville, Tennessee. Cardiac patients are most affected by medication errors, said WebMD, even when they receive extra assistance from pharmacists.

While prior studies revealed that about 20% of all heart patients undergo some type of prescription medication problem following discharge, the new study reveals that these types of errors are more widespread than first believed. The Institute of Medicine of the National Academies points out that drug errors affect some 1.5 million people in the U.S. annually. “We found that approximately 50% of patients had either a potentially avoidable adverse drug event or some other problem with their medicine that had the potential to cause harm if left uncorrected,” researcher Sunil Kripalani, MD, associate professor of medicine at the university school, told WebMD. Most errors were mild, none were fatal, but some were life threatening, Dr. Kripalani added.

Patients with challenges understanding health information, for instance, seemed to benefit from the extra pharmaceutical help; however, errors did occur in those who received extra pharmaceutical counseling, wrote WebMD. The study is published in the Annals of Internal Medicine.

The researchers and looked at 851 patients—on average about 60 years of age—who had been hospitalized at either Vanderbilt University Hospital or Brigham and Women’s Hospital in Boston with heart problems, said WebMD. Half were assigned extra pharmaceutical assistance; the other half received standard care. Pharmacists counseled patients in the extra-care group in one or two sessions on ways in which to reduce medication errors; evaluated how well patients understood medication instructions; discussed the patient’s support network; provided patients with pill boxes and illustrated drug schedules; and followed up with the patients, by telephone, one to four days following discharge. The comparison group received information about their medications from their physician and hospital nurses at discharge, said WebMD.

Researchers tracked drug errors for one month following discharge and found that more than half—432 patients—experienced at least one error The usual care group experienced 407 “clinically important” medication errors versus 307 in the extra-help group, said WebMD. Seven errors in each group were life threatening and involved diuretics; opioids for pain; herbs, vitamins, and supplements; and heart disease, cholesterol, diabetes, and anti-clotting drugs.

The researchers noted that some errors could have been avoided by closer pharmacist and physician monitoring; common mistakes included missed or incorrect doses, not filling prescriptions or stopping medicine too soon, and taking drugs more or less often than prescribed, said WebMD. “What our subgroup analysis hinted at is that patients with more complex medication regimens, those with low health literacy, patients who tend to have more trouble understanding and managing their health, and those who had cognitive problems, tended to benefit more,” said Dr. Kripalani.

Allen Vaida, PharmaD, executive vice president of the Institute for Safe Medication Practices, who reviewed the findings for WebMD, said that the 50% finding is surprising. Errors occurring at hospitals with reputations for providing excellent programs to minimize medication errors, “should be a wakeup call,” he said. The study suggests that simply speaking with patients about their medications at discharge is not sufficient, Cynthia Reilly, a spokeswoman for the American Society of Health-System Pharmacists, told WebMD.

Dr. Kripalani pointed out that patients should take steps to reduce medication errors: Ensure questions are answered before discharge, have a “lifeline” person to contact once home, and exercise extra attention to prescriptions just after discharge, said WebMD. Vaida also suggested patients have all their prescriptions filled at one pharmacy to ensure a master list is maintained in one place, develop a relationship with the pharmacist, and secure an advocate among family and friends for assistance.

We previously wrote that the older population is more susceptible to the dangers of drug mixing than other groups, with one in 25 older Americans—about 2.2 million people—at risk for serious health problems because they take dangerous drug combinations that in about 50 percent of the cases include nonprescription medications and supplements. We also previously wrote that a Canadian study found that adverse drug reactions account for a significant number of emergency room visits in that country annually, highlighting the link between some medications and serious health problems. The study also found that non-adherence—when patients don’t take drugs as described—was responsible for about 30 percent of medication-related ER visits.