27 January 2011

Hospitals Medically Abuse Elderly Leaving the ICU

This is easy to believe. This study presented to the Society of Critical Care Medicine 40TH Critical Care Congress said that more than half of of the elderly admitted to the intensive care unit (ICU) receive prescriptions for drugs they do not need when it is time to go home.

A lot of terms are used. Potentially inappropriate medications (PIMs) and overtly inappropriate medications (AIMs) are the terms. The researchers were very careful in the use of terms and how they described medications. They left out many possibilities for the reasons these medications were prescribed. This does bother me that hospital doctors are doing this. Without knowledge of what the medications were, I will withhold my speculation at this point.

There are some drugs that are generally inappropriate, but turn out to be appropriate in a clinical setting. Such drugs should be stopped at discharge because they are no longer needed. Having a lot of drugs in the elderly creates problems of cognitive function, increases the risk of falls, and healthcare costs.

In addition, a hospitalist, geriatrician, and a clinical pharmacist evaluated whether PIMs medications at discharge were also AIMs by looking at their indication, efficacy, dosages, and drug interactions. It is disturbing that some patient receiving 3 or more PIMS before admission was 16 percent, but increased to 38 percent at hospital discharge. Other increases were even greater.

This study points out why if you have elderly parents, you should know what medications they are taking when they enter the hospital and then know what is absolutely necessary when they are discharged. Make sure that the primary care doctor for them is also aware of this. Make sure that you have the necessary powers to take care of them medically to make sure that they are not over-medicated on purpose or even by accident. If they are capable, just check the prescriptions to make sure they are not over-medicated.

To me this is necessary. Read the entire article here and see if you don't agree.

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