Medication Safety: Who’s At Risk

Today’s medicines cure infectious diseases, prevent problems from chronic diseases, and alleviate pain for millions of Americans. But medicines can also cause harm. Adverse drug events cause over 700,000 emergency department visits each year. Patients and their families can do a number of things to help reduce the risk of harm from medicines.

One of the most important things patients can do to keep themselves and their families safe is to learn how to properly take, monitor, and store their medicines.

What Is Medication Safety and What Are Adverse Drug Events?

Medication safety includes a number of things that patients can do to make sure that they get the most benefit from medications with the least risk of harm. When someone has been harmed by a medication, they have had an adverse drug event.

Are Adverse Drug Events a Big Problem?

There are many ways to measure the size of the problem of medication safety. Recent work at CDC has focused on the short-term, severe problems of medicines taken by people outside of hospital settings. It is estimated that there are more than 700,000 visits to emergency departments for adverse drug events each year in the United States. Nearly 120,000 of these patients need to be hospitalized for further treatment. This is an important patient safety problem, but many of these adverse drug events are preventable.

Who Is At Risk for Adverse Drug Events?

Anyone who takes medicines has some risk of a harmful effect. How high that risk is depends on the individual patient’s health, the particular medicines a patient is using, and how patients use their medicines. Nevertheless, national data suggest there are some key risks and risk groups:

  • Young Children: Children less than 5 years old are twice as likely as older children to be taken to emergency departments for adverse drug events (nearly 98,000 emergency visits each year). Most of these emergency visits are due to young children finding and eating or drinking medicines on their own, without adult supervision.
  • Older Adults: Older adults (65 years or older) are also twice as likely as others to come to emergency departments for adverse drug events (over 177,000 emergency visits each year). Older adults are nearly seven times more likely to be hospitalized after an emergency visit, but most of these hospitalizations are due to just a few drugs known to require careful monitoring to prevent problems. Common drugs that can require monitoring are blood thinners (e.g., warfarin), diabetes medications (e.g., insulin), seizure medications (e.g., phenytoin), and digoxin (a heart medicine).
  • All Adults: The death rate from unintentional prescription drug overdoses is highest among middle-aged adults (40-49 years old). In 2004, over 7,500 Americans died of unintentional overdoses of opioid (or narcotic) analgesics (pain medications such as methadone, oxycodone, and hydrocodone), more people than from cocaine or heroin.

What Can Patients Do?

All patients

  • Know your medicines. Keep a list of the names of your medicines, how much you take, and when you take them. Include over-the-counter medicines, vitamins, and supplements and herbs. Take this list to all your doctor visits.
  • Follow the directions. Take your medicines exactly as prescribed. Don’t take medications prescribed for someone else.
  • Ask questions. If you don’t know the answers to these questions, ask your doctor or pharmacist.
    • Why am I taking this medicine?
    • What are the common problems to watch out for?
    • What should I do if they occur?
    • When should I stop this medicine?
    • Can I take this medicine with the other medicines on my list?

Parents of young children

  • Store medicines safely. Keep all medicines stored securely, out of the reach of children. Leave medicines in their original packaging and make sure the caps are always secured. Never tell children that medication is candy.
  • Avoid unnecessary medicines. Antibiotics and cough and cold medications will not cure most colds, coughs, flu, sore throats, or runny noses. These medicines can sometimes cause more harm than good.

Adults and older adults

  • Take pain relievers only as directed. If you are taking opioid pain relievers, be sure to tell your doctor about all other medicines you are taking because some medicines, when taken with pain relievers, can cause an adverse drug event, such as an overdose.
  • Ask if you need blood testing. If you take any medicines that require special testing, pay particular attention to taking these properly and get regular blood testing. Common medicines that can require monitoring are blood thinners (e.g., warfarin), diabetes medications (e.g., insulin), seizure medications (e.g., phenytoin), and digoxin (a heart medicine).