On July 17, 2015, the Centers for Medicare and Medicaid Services sent a memo to state health departments warning of the danger of misuse of the common blood-thinner Coumadin for nursing home residents, requesting that state health inspectors pay increased attention to errors by nursing homes in managing Coumadin that lead to resident hospitalizations and resident deaths, citing a report co-published by ProPublica that appeared in The Washington Post.
Coumadin is an anticoagulant (blood-thinner) that many nursing home residents are prescribed for various chronic and acute medical conditions. Coumadin can save the lives of those who need it. However, too much Coumadin may cause uncontrolled bleeding and too little Coumadin may result in insufficient anticoagulation for nursing home residents, leading to serious or fatal medical consequences such as blood clots and strokes.
A 2007 study estimated that approximately 34,000 fatal, life-threatening, or serious adverse events occur each year due to Coumadin. The recently published ProPublica report analyzed the results of government inspections of nursing homes and determined that at least 165 nursing home residents died or were hospitalized between 2011 and 2014 due to medication errors involving Coumadin and warfarin (Coumadin’s generic version). Approximately one-in-six of the 1.3 million nursing home residents in the United States are prescribed an anticoagulant, with the majority of them taking warfarin or Coumadin. The U.S. Department of Health and Human Services identified Coumadin and other anticoagulants in 2014 as a category of drugs that is frequently implicated in adverse drug events.
Nursing home residents and others taking Coumadin or warfarin must have regular blood testing done to measure and adjust the anticoagulant level and effect. If the level of anticoagulation when on Coumadin is too great, the effect can be treated with vitamin K. People who take Coumadin or warfarin must also avoid certain foods.
Newer anticoagulants (Xarelto, Pradaxa, and Eliquis, which are heavily advertised by their respective manufacturers directly to consumers) have the benefit of not having to undergo regular and routine blood testing or having to avoid certain foods. However, patients taking newer anticoagulants run the risk of uncontrolled bleeding under certain circumstances for which there is no antidote (vitamin K does not reverse the effects of the newer blood thinners).
(ProPublica is an independent, non-profit newsroom that produces investigative journalism in the public interest. ProPublica has an independent newsroom located in Manhattan where about 45 working journalists are dedicated to investigative reporting on stories with significant potential for major impact. ProPublica has had 121 publishing partners since 2008. ProPublica is a non-profit corporation, and is exempt from taxes under Section 501(c)(3). Source)
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