Many Get the Wrong Drugs in Emergency Rooms

Many older Americans end up getting the wrong drugs as part of their emergency room treatment, a new study says.

Nearly 17 percent of those over age 65 who visited emergency departments from 2000 to 2006—some 19.5 million people—were sent home with “potentially inappropriate medications,” according to estimates in a study published in March in Academic Emergency Medicine.

“Emergency departments should do a better job of choosing the right medications for older adults,” says the study’s lead author, William Meurer, M.D., of the University of Michigan Medical School. He advises older patients to:

• contact your primary-care doctors while you are in emergency care.
• make sure to tell ER staffers which drugs you normally take.
• keep a list of the drugs you are given in the hospital.
• promptly report any problems or side effects.

For their part, Meurer says, emergency-care doctors should more carefully select the drugs they prescribe for older patients. “Some of those drugs can have prolonged impact on older adults, and there are alternative medications that are safer,” he notes.

His team analyzed a national sample of reports, designed by the U.S. Centers for Disease Control and Prevention, on patients treated at emergency rooms or clinics and sent home. For all the patients over age 65, they tracked the prescribed drugs that are on the Beers list—a list of drugs that a panel of experts do not recommended for older adults. Meurer’s paper lists ten medications—including anti-inflammatory medications, narcotics, and anti-nausea drugs—that accounted for 86 percent of the inappropriate drugs prescribed.

The study “is very important because it highlights the need for improvement” in determining which medications are given to older people in emergency care, says Manish Shah, M.D., an expert in geriatric emergency care at the University of Rochester Medical School in New York state. But Shah cautions that the findings “should be taken with a grain of salt, because some of those medications need to be used in certain cases.”

Robert Koenig is a medical and science writer in Washington, D.C.