The blood thinner Coumadin (or warfarin) is a widely used drug in this country. It is often prescribed for older adults for the prevention of strokes, blood clots and heart attacks. But its use must be closely monitored. Too much can lead to internal bleeding. Too little can allow blood clots to form.
Knowing this, it stands to reason that nursing homes in particular would be hyper-vigilant about monitoring Coumadin in their patients, right? The evidence suggests otherwise.
The investigative journalists at ProPublica studied government inspection reports and found that from 2011 to 2014, at least 165 nursing home residents were hospitalized or died after errors involving Coumadin or its generic version, warfarin. Studies suggest there are thousands more injuries every year that are never investigated by the government.
For example, 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 each year. And there's data from North Carolina that shows more medication errors in nursing homes involving Coumadin than any other drug.
Doctors agree the drug has great benefits. So, what's to be done? The ProPublica analysis suggests that Coumadin deaths and hospitalizations should get more attention from the Centers for Medicare and Medicaid Services, the federal agency that regulates nursing homes. Federal inspection reports repeatedly cite the same type of problems; patients not getting the drug as ordered, or given the wrong doses, or given without a doctor's order or adequate monitoring.
According to federal data from earlier this year, about 1 in 6 of the nation's 1.3 million nursing home residents take a blood thinner. The majority are believed to be on Coumadin or its generic.