Drug Side Effects A Leading Killer

Imagine a condition that causes millions of hospitalizations and hundreds of thousands of deaths each year. By some accounts, it is the third leading cause of mortality in this country, right after heart disease and cancer.
With numbers like that, every doctor should be aware of this public health menace and doing everything possible to control the epidemic. But for the most part, the crisis is being ignored.
All this misery is caused by harmful reactions to medications. Researchers call them adverse drug events (ADEs), but most people refer to them as side effects.
A recent article in the Journal of the American Medical Association (March 5, 2003) documents the seriousness of this problem among Medicare recipients. Over 27,000 older people were followed for twelve months. During that time researchers identified 1,523 ADEs, of which more than a quarter could have been prevented.
The investigators also concluded that “Serious, life-threatening, and fatal adverse drug events were more likely to be preventable than less severe events.” Nearly half of these severe side effects should have been avoided.
Generalizing from the study to the entire Medicare population, the scientists estimate that nearly 2 million ADEs, more than a quarter of them preventable, occur every year. And if the statistics hold up, Medicare recipients experience more than 180,000 deadly or life-threatening drug reactions annually. In many situations, the cure is worse than the disease.
Older people are more susceptible to such problems. For one thing, they take more medications. More than 90 percent of Americans over 65 use at least one medicine a week, and more than 40 percent take 5 or more drugs in a week.
The more pills someone swallows, the greater the risk of a serious side effect or a dangerous drug interaction. We heard from one reader about his wife’s untimely death:
“My wife’s health started to deteriorate after heart surgery. Until that time she had only been on baby aspirin. Then she developed type 2 diabetes and was put on other medicines. In the space of six months she had to be hospitalized six times. At least two visits were caused by drug interactions. During one episode her blood sugar fell to 14 [normal range is 65 to 115] and almost killed her.
“Each specialist may know the drugs in his particular field, but no one was interested in the whole picture but me. It’s unrealistic to expect the patient to know which side effects or interactions are serious.”
People don’t always think of bruising or dizziness as important, but bruising can signal excessive bleeding and dizziness may lead to a fall, with potentially disastrous consequences.
To prevent such problems, patients and their families need to know what side effects are most common and which are most dangerous. Even more important, they need to know what to do in case they suspect they are experiencing an adverse drug event.
To assist with this process we have prepared a free Drug Safety Questionnaire, which should be filled out by the prescribing physician. To request a copy, please send a long (no. 10) stamped, self-addressed envelope: Graedons’ People’s Pharmacy, No. QH-3, P. O. Box 52027, Durham, NC 27717-2027.