Prescription drug deaths

Special report: Prescription medicines
Deaths from prescription drugs more than double in 10 years
Published: 21 October 2007
http://news.independent.co.uk/health/article3081840.ece


Thousands of patients are dying each year as a result of side effects from pills prescribed by GPs and hospital doctors.
And while the number of deaths from suspected adverse reactions to prescription drugs has more than doubled in the past 10 years to 973 last year, medical experts warn that as few as one in 10 deaths and other serious complications are being reported.
Doctors' poor prescribing skills and repeated failures to recognise accurately adverse drug reactions in patients have seen deaths multiply by about two and half times since 1996.

...today's revelations highlight a 155 per cent rise in reported deaths from adverse reactions to prescribed and over-the-counter drugs – a far steeper increase that will shock the both medical profession and patient groups.

An international conference on drug safety which convenes in Bournemouth tomorrow will hear that "too little progress" has been made in the past 15 years in training doctors to use medications more safely.

Professor Saad Shakir, director of the Drug Safety Research Unit at Southampton University, said: "Doctors need to know how to use medications – this is the most important ethical responsibility for us. Surgeons wouldn't conduct an operation they haven't studied and trained for, and these same standards should apply to medications.

"The competence of doctors in understanding medicines, knowing when and how to use them and how to recognise problems is as essential as training a surgeon in how to perform an operation. Using medicine should be a part of medical training and the ongoing monitoring and evaluation of doctors."
"In recent years, there has been less pharmacology taught in medical schools, but if you consider the growing number of drugs available and the trend towards combination therapies, then this does seem to go against the grain."

A failure by doctors to make the difficult distinction between adverse reactions and disease symptoms can prove potentially fatal, as patients may be given drugs that are more harmful than helpful. According to patient groups, doctors and other health professionals do not always take the suspicions of patients and relatives sufficiently seriously.

Penny Bunn was prescribed anti-depressants by a psychiatrist in 1998 when she was a slim 30-year-old broadcast assistant at the BBC. Five years later, she was in hospital with kidney and liver damage, weighing 20 stone. Eventually she was diagnosed as suffering adverse reactions to her prescribed drugs.
As well as serious weight gain, she experienced blurred vision, vomiting, jaundice, irregular periods, agitation and difficulty passing urine. But because none of these symptoms was recognised as adverse drug reactions, Ms Bunn was prescribed more and more medication, eventually leaving her close to death.
She said: "We now know that I am allergic to all anti-depressants. However, rather than even consider this as an option at the time, the consultant psychiatrist continued to blunder blindly on, misdiagnosing all the reactions I was having as being evidence of further psychiatric disorders.

"No medical personnel ever mentioned anything about side effects or interactions, yet I now know some of the medications I was given are not meant to be used together. How the psychiatrist managed to sit there, as I changed before his eyes, and never cotton on to the fact that there was something horribly wrong with what he was doing, I do not know."


Sedatives and sleeping pills raise suicide risk in the elderly FOUR fold, researchers warn
By Cher Thornhill
Last updated at 2:00 PM on 04th June 2009
http://www.dailymail.co.uk/health/article-1190802/Sedatives-sleeping-pills-raise-suicide-risk-elderly-FOUR-fold-researchers-warn.html

Vulnerable elderly people prescribed sedatives or sleeping pills may be more likely to take their own life, a study suggests.
The drugs, which are prescribed to ease depression, anxiety and problems with sleep, raise the risk of suicide among the elderly four fold , the Swedish researchers found.

‘Clinicians need to be aware of this as these drugs are widely prescribed to the elderly,’ the researchers warn.

The team reviewed figures for the Swedish city of Gothenburg along with two nearby counties and found that older people taking antidepressants, antipsychotics, sedatives or hypnotics were all more likely than others to commit suicide.

While research has linked use of these drugs to suicides among younger people, there had also been evidence the pills may reduce the risk in the elderly, Anders Carlsten and Margda Waern of Gothenburg University reported in the journal BMC Geriatrics.

To find out, they compared the records of 85 men and women older than 65 who had committed suicide with those of 135 elderly people from the general population who had not.

Psychiatrists interviewed people close to the patients about mental problems over the past month and the volunteers were also interviewed in person.
After taking account of the diagnosed psychiatric conditions, the team found that patients who took sedatives and hypnotics for sleeping problems were four times more likely to commit suicide.

According to the World Health Organisation, some 877,000 people worldwide kill themselves each year.

For every suicide death, anywhere from 10 to 40 attempts are made, the U.N. agency estimates

Scientists have linked sleep disturbances to an increased risk of suicide in people with psychiatric disorders and in adolescents but it is unclear whether the association also exists in the general population.

‘A careful evaluation of the suicide risk should be carried out when an elderly person presents with symptoms of anxiety and sleep disturbance,’ the researchers said.

While they do not know exactly why, Carlsten and Waern suggested that the drugs somehow trigger aggressive or impulsive behaviour or provide the means for people to take an overdose.

However, disabilities or sleep problems may make people more likely to commit suicide, they added.

‘[People] with these problems might be more likely to seek health care and perhaps more likely to receive prescriptions for psychotropic drugs,’ they said.

Sophie Corlett, External Relations Director at mental health charity Mind said: 'Any research that links a drug treatment with increased risk of suicide is alarming, and further research is needed to clarify the role that sedatives might play.
 
'We know that older people can be routinely over-prescribed or given inappropriate medication for the sake of convenience, and health professionals must act responsibly and be alert to the damage some medications can cause.'


Doctor accused over death of 12 elderly patients who were 'over-sedated and left in comas'
By Daily Mail Reporter
9th June 2009
http://www.dailymail.co.uk/news/article-1191587/Doctor-accused-death-12-elderly-patients-sedated-left-comas.html

Twelve elderly patients died after being over-prescribed painkillers and sedatives by the same doctor, a disciplinary hearing was told yesterday.

Dr Jane Barton prescribed strong opiates in 'excessive' doses, leaving the men and women in 'drug-induced comas', the hearing was told.
 
Many died within days of coming under her care on two wards at the Gosport War Memorial Hospital, Hampshire, between 1996 and 1999

Opening the General Medical Council hearing, Tom Kark, for the GMC, said the elderly patients expected to be rehabilitated and sent home. But the two wards concerned, Dryad and Daedalus, became known as 'the end of the line'.
 
Many of the patients had never been given opiates before, but Dr Barton wrote prescriptions for drugs, including diamorphine, which allowed nursing staff to increase dosage massively if they saw fit.

Police carried out three separate probes into 92 suspicious deaths at the hospital in the late 1990s, referring ten cases to the Crown Prosecution Service, but no charges were brought.

Dr Barton, who graduated in medicine from Oxford University and still works as a GP, took charge of the two wards in 1988.

She would do two hospital rounds during the morning and then attend to her other GP work, leaving nurses with much of her authority.
 
In many cases, as soon as a patient was admitted - even ones previously described as 'well and happy' - she wrote on their notes: 'I'm happy for nurses to confirm death.'

Mr Kark told the hearing: 'Many of the patients you're going to hear about... had not been given opiates as a form of pain relief nor apparently required them. None of the patients were appropriately prescribed opiates by Dr Barton.
'There was, we say, a series of failures which led to patients being overmedicated and unnecessarily anaesthetised.'

The 12 who died were: Leslie Pittock, 82, Elsie Lavender, 83, Eva Page, 87, Alice Wilkie, 81, Gladys Richards, 91, Ruby Lake, 84, Arthur Cunningham, 79, Robert Wilson, 74, Enid Spurgin, 92, Geoffrey Packman, 68, Elsie Devine, 88, and Jean Stevens, whose age was not given. Mrs Lake was admitted to the Dryad ward on August 18, 1998, after a hip operation and was described as mobile, lucid, well and happy.

However Dr Barton prescribed sedatives diamorphine and midazolam, to be administered by an automatic syringe. Three days later Mrs Lake was dead.
 
Mr Kark said: 'It is likely that this patient died not from illness but as a result of the combined effects of the drugs in her system.'
Barton admits that the dosage prescribed for 11 of the 12 patients was 'potentially hazardous', that for 11 a situation where excessive drugs could be administered had been created, while for ten the dose range was too wide.

She also admits she failed to keep clear, accurate and contemporaneous notes in relation to some or all of her patients.

She denies serious professional misconduct.
The hearing continues.