Experts from the University of Iowa recently published a study in the Journal of the American Geriatrics Society examining the kind of medication errors and side effects that nursing home residents experience. They also looked at staffing and work systems in nursing homes that could affect medication errors and side effects. This is important because more than 1.4 million older adults lived in nursing home facilities as of 2015. Of these, 85% were age 65 years and older and 41% were age 85 years or older. In 2014, there were 15,600 nursing homes in the United States.

Older adults who live in nursing homes are at greater risk for injuries related to the medications we might take as we age (these injuries are also known as “adverse drug events”). There is a greater risk for adverse drug events for this population due to age, frailty, disability, and the multiple chronic illnesses we may be managing at any given time. For these illnesses, nursing home residents usually need several medicines, sometimes including riskier medicines like antipsychotics, antidepressants, and antiepileptics.

Some adverse drug events are due to preventable errors. Others are considered “non-preventable” because they can occur even when the medications are correctly given at normal doses.

The researchers collected their information from 11 nursing homes located in nine cities in Iowa between fall 2016 and spring 2017.

The residents lived in the nursing homes ranging from a few days to 34 years. The average age of residents was 81.5 years, and two-thirds of the residents were women.

The researchers found that half of all the nursing home residents took nine or more medicines. Additionally, older adults were at higher risk of bleeding due to taking blood-thinning medications. Medicines taken for diabetes increased the risk for low blood sugar, which can cause dizziness and falls. Finally, tranquilizers and sleeping medications were observed to increase the risk for falls, particularly among residents with dementia. (These medications can also cause problems with thinking and making decisions.)

As mentioned above, nursing home residents have risk factors, such as older age, disability, illnesses, and taking multiple drugs. They also faced risk factors due to nursing home organization problems, including the presence of staff members who might be unaware of high-risk medications. Not having enough trained staff members contributed to the problem, said the researchers.

Nurses often experience interruptions when they’re preparing or giving medications to nursing home residents. These conditions increase the rate of medication errors. Another concern leading to medication errors is that nursing home staff members may have limited access to resident physicians and do not get to work closely with them.

The researchers learned that of the residents who experienced adverse drug events:

•64% had high blood pressure
•44% had dementia
•36% had depression
•14% had generalized muscle weakness