It is being reported that Coumadin, the popular prescription blood thinning drug, is a particular problem in nursing homes and requires careful calibration in that too much can cause uncontrolled bleeding and too little threatens the development of life-threatening clots. A story in the Washington Post reported that at least 165 nursing homes residents were hospitalized or died following errors from ingesting Coumadin or its generic version, warfarin, from 2011 to 2014.
The reporter, Charles Ornstein, derived his information from ProPublica that analyzes consumer and government data. “Studies suggest there are thousands more injuries every year that are never investigated by the government,” Ornstein wrote. He also quoted Ron Baird, president of Geriatric Practice Management, a firm that creates electronic health records for physicians working in long-term care facilities, who said that “‘Coumadin is the most dangerous drug in America.'” Ornstein reported, though, that a national initiative helped reduce the use of such drugs by about 20 percent. Still, a 2007 study in the American Journal of Medicine estimated that nursing home residents suffer 34,000 fatal, life-threatening or serious events related to the drug every year, according to the Washington Post story.
The drug has been around since the 1940s, and even President Dwight D. Eisenhower was prescribed the medication after suffering a heart attack. The drug has been reported to interact poorly with certain foods and other medications, particularly antibiotics, and requires regular blood tests to ensure that it is working properly. Ornstein reported that 2.4 million seniors and disabled people filled at least one prescription for warfarin, the generic of Coumadin in 2013 under Medicare’s prescription program and some 280,000 people were prescribed the brand-name version, Coumadin and Jantoven. He also reported that about 1 in 6 of the nation’s 1.3 million nursing home residents are prescribed an anticoagulant, according to federal data from this year, with the majority believed to be on Coumadin or its generic.
It should be noted that in a study published last year by Quest Diagnostics, a lab company, that the drug Coumadin or its generic had the desired effect on patients only 54 percent of the time. The story also reported of a 2011 report in the New England Journal of Medicine that the drug accounted for some 33,000 emergency hospitalizations among the elderly from 2007 to 2009, more than twice as many as the next highest drug, insulin for diabetes. To read more about this important development, click here.