Aging: Troubles in the Medicine Cabinet

By JOHN O'NEIL, NY Times

 March 11, 2003 

Surveys show that almost half of Americans over 65 take five or more different medicines a week.

The study examined records from a large medical practice that covered about 30,000 older patients. While doctors caused most of the errors it found, patients were responsible for many problems as well, said the study's lead author, Dr. Jerry H. Gurwitz, the executive director of the Meyers Primary Care Institute in Worcester, Mass. Mistakes by patients included continuing medicines when told to stop, taking the wrong dose and taking pills prescribed for someone else.

The study, published last week in The Journal of the American Medical Association, found that a little more than a third of what it called adverse drug events — illnesses going beyond standard side effects — were serious or life-threatening. Eleven patients died as a result of the drug problems.

Dr. Gurwitz said that one class of drugs, anticoagulants, was a particular problem. The drugs, used to prevent blood clotting, interact with many other medicines and need careful monitoring to assure that the blood is not being made too thick or thin, he said.

Solutions proposed by the study include computerized systems that warn of interactions and remind doctors of the need for follow-up testing. Another measure, Dr. Gurwitz said, is for doctors and patients to talk about drugs more thoroughly.