Treatment more harmful than misdiagnosis in the elderly

Shoen7754 shoen7754 at AOL.COM
Sat Sep 19 01:59:39 UTC 2015



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> On Sep 18, 2015, at 6:14 PM, Peggy Zuckerman <peggyzuckerman at GMAIL.COM> wrote:
> 
> Dear Ruth,
> Last year at the Patient Summit, Helen Haskell had a local man, a consulting pharmacist, Armon Neel, speak to the gathering.  He works on behalf of Georgia to monitor nursing homes as to the patients' use of meds.  He says he isn't very popular with some of the doctors, but reminds them that the elderly liver and kidney cannot metabolize meds like their younger counterparts.
> 
> On my own kidney cancer forums, there was a recent inquiry about an elderly man with one kidney, suddenly in the hospital and 'dying' per his own doctor,  Seems he had gone to his GP, doing quite well as to the kidney cancer, but the GP didn't like his blood pressure.  Two days later in the hospital, with a sudden dementia, unable to eat or drink. Doctor was saying to 'let him go', but advice from other patients led the daughter to demand an IV and stopping of the meds.  The man is now home again, trying to make up for last time in his toolshop.
> 
> For eleven years I have had only one kidney and am very involved in this advocacy.  It was not until I heard Armon Neel that I realized that no one in my cancer world had ever indicated that we one-kidney types should monitor our standard medications.  Scary.
> Peggy 
> 
> Peggy Zuckerman
> www.peggyRCC.com
> 
>> On Fri, Sep 18, 2015 at 12:41 PM, Ruth Ryan <ruthryan at cox.net> wrote:
>> New article in Annals of Family Medicine cites a study in New Zealand from malpractice claims data showing that the elderly are more at risk from treatment errors, particularly medications than medical error.  Misdiagnosis is far down the list, #12.
>> 
>>  
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>> Authors conclude, “The no-fault perspective reveals the greatest threat to the safety of older patients in primary care to be, not error, but the risk posed by treatment itself. To improve patients’ safety, in addition to reducing error, clinicians need to reduce patients’ exposure to treatment risk, where appropriate.”
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>> In my view, the cascade of new recommendations to prescribe statins to virtually everyone, meds and combination meds to ratchet down cholesterol, blood pressure and blood sugar to ever lower levels ignores the special risks of polypharmacy to the elderly. As we are beginning to see with some screening recommendations, there might be a good age to quit doing that.
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>> It’s also interesting to read about the no-fault approach to compensation for harm from medical treatment.
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>> Ann Fam Med 2015;13:472-474. doi: 10.1370/afm.1810. http://annfammed.org/content/13/5/472.full.pdf+html
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>> Ruth
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>>  
>> 
>> Ruth Ryan RN, BSN, MSW, CPHRM
>> 
>> Medical writer
>> 
>> Risk management/patient safety
>> 
>> Continuing medical education
>> 
>> Telephone (504) 256-8797
>> 
>> Email ruthryan at cox.net
>> 
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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