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A small study finds that even adults who know what medicines they take at home can’t accurately name the drugs they’re getting in the hospital.

Forty-four percent of patients believed they were receiving a medication in the hospital that was not actually prescribed. A patient who normally receives a blood pressure medicine, for example, may have thought the medicine was continued when, in fact, it was not.

Ninety-six percent of patients failed to recall one or more of the medicines that they had been prescribed during their stay, according to the study, which is published Dec. 10 in the Journal of Hospital Medicine.

“I don’t think that’s surprising at all. I think that that’s the natural consequence of the way in which hospital culture is designed. Patients are given their medicines and they take their medicines,” said study author Dr. Ethan Cumbler, an assistant professor of medicine at the University of Colorado Denver and director of the University of Colorado Hospital Acute Care for the Elderly Service.

“It’s actually a very different culture than what goes on in the outpatient setting, where patients actually are expected to know what they were taking, when they’re supposed to take it and for what reason,” he explained.

But the stakes are just as great — if not greater — in the hospital.

Say an antibiotic was prescribed. If the patient was allergic to a particular antibiotic and knew which drug he or she was about to receive, that person could play a role in averting the medication error before the drug was administered, Cumbler reasoned.

Or, a kidney transplant patient normally takes certain medicines to prevent rejection of the organ, but a dose might be accidentally skipped.

“If the patient knows what medicines they’re supposed to be getting and when, then they’re sort of one extra layer of protection to make sure that things go well,” he said. “If they don’t know what medicines they’re supposed to be getting or when, then they are dependent on hospital systems to work flawlessly, and the sad fact is that hospital systems in any hospital don’t work flawlessly.”

Kevin Colgan, corporate director of pharmacy at Rush University Medical Center in Chicago and immediate past president of the American Society of Health-System Pharmacists, was surprised that so many patients did not know what drugs their doctor has prescribed.

“It means that evidently it was not well-communicated with them what their plan of care was,” he said.

To catch medication errors, patients first have to know something about the medicines they’re taking. So for this study, Cumbler and colleagues surveyed 50 adults between the ages of 21 and 89 at the University of Colorado Hospital. All were knowledgeable about the medicines they were taking before admission.

Patients were then asked to write down all the medicines they thought doctors were prescribing for them while they were in the hospital. Researchers compared that list to the actual medication administration record — the list of medications that were being given to them in the hospital.

Medicines prescribed but not listed by the patient counted as errors of omission, while medicines listed by the patient but not actually prescribed counted as errors of commission.

On average, patients omitted 6.8 medications, most commonly antibiotics (17 percent), cardiovascular medications (16 percent) and antithrombotics (15 percent), the researchers found.

Only 28 percent of patients said they’d seen their hospital medication list, although 78 percent would like to have been given such a list, and 81 percent said it would improve their satisfaction with their care, the study authors noted.

“There are a group of patients that want to be more involved,” Cumbler noted, “and I think this raises the question, ‘How can we help them be more involved?’”

What’s more, for some patients, especially those who are older and cognitively impaired, more involvement may not be desirable and, in fact, may have disadvantages, he noted.

Colgan described a number of things patients can do to get more involved in their own medication management:
Keep a list of medications you take so you can provide an accurate medication history when you check into the hospital.
During your stay, ask: “What’s that name of the drug you’re giving me? What will it do? And what adverse drug reactions should I expect?”
Before discharge, learn about any medications you’ll be taking at home.

If you or a loved one has epilepsy, there are things you can do at home to reduce the risk of an injury during a seizure.

The Epilepsy Foundation offers these suggestions:
Make sure your home is well carpeted and padded underneath.
Cover any sharp corners on furniture with padding.
Always close fireplace screens when the fireplace is lit. People with epilepsy should avoid lighting a fire or carrying lit candles.
When buying space heaters or any type of iron, look for these and similar appliances with an automatic turn-off function.
Use chairs that have arms, making a fall less likely.

Mary Poppins was right - a spoonful of sugar does help.

New research from Brazil suggests that sugar and hugs appear to reduce the pain felt by newborns when they are given a shot, more so than sugar (dextrose) or skin-to-skin contact alone, or standard care.

The study, published this week in the journal Pediatrics, suggests that simple inexpensive steps could have a big effect on newborns.

In the largest study ever conducted on newborn pain, Brazilian researchers randomly assigned 640 newborns to four analgesia groups of 160 each: no analgesia, dextrose on the tongue, skin-to-skin contact with mom (holding), or dextrose and holding by mom. (1101-c2-p4)

Standard pain gauges, including facial expressions, crying duration, and heart rate, were used to gauge newborn pain during and after a routine vaccination. Which newborns received dextrose or plain water was not known by the researchers, but it was impossible to obscure which newborns were being held, making this study only partially blinded.

Combining skin-to-skin contact and a drop of dextrose to the newborn’s tongue 2 minutes prior to the needle stick led to a “significant” reduction in pain scores compared to either technique alone, or no-analgesia, the investigators found.

The typical healthy newborn undergoes a number of routine but painful procedures before leaving the hospital including immunization, blood collection and intramuscular injections.

Distraction and other techniques to reduce stress and pain in adults and children do not work in newborns, according to Duke University School of Nursing professor, Dr. Diane Holditch-Davis. As a result, doctors have sought other strategies.

Previous smaller studies have identified the pain reduction benefits of 10 to 30 minutes of skin-to-skin contact or a dose of sugar water separately.

Holditch-Davis works with the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) to develop and evaluate guidelines for the care of infants. The sugar and hug technique of pain control “is a very conservative and reasonable” method for comforting newborns, she told Reuters Health in a telephone interview.

Implementation, she said, should have a “trivial impact” on staff workloads.

The current study found that holding for as little as 2 minutes prior and 2 minutes following needle stick was sufficient, Holditch-Davis noted. “That makes the technique even more feasible to do because less planning is needed. The baby can be handed to the mother for the several minutes it takes the nurse to prepare the injection,” she pointed out.

The pain relief achieved through holding involves more than just skin-to-skin contact, Dr. Ruth Guinsburg, professor of pediatrics, Federal University of São Paulo, Brazil, who was involved in the study, noted in an email to Reuters Health.

This suggests mom, not substitutes, are involved in achieving pain relief.

“The touch and smell of the mother and the sound of her heartbeat may block” pain signals to the central nervous system or may fuel the release of the body’s own pain-relieving hormones, the investigator say. New studies are needed to understand the mechanism underlying this simple non-drug pain-relieving approach.

In the meantime: “I hope that our results will encourage neonatologists, pediatricians and nurses to apply simple, non-expensive non-pharmacological analgesic strategies to decrease pain triggered by routine procedures performed in healthy neonates,” Guinsburg said.

Holditch-Davis, agreed. “There’s no harm in doing any of these things and it doesn’t take that much time so, why wouldn’t you do it?” she said.

Certain types of chemotherapy can cause heart problems, and cardiologists and oncologists need to work together to protect patients, especially those at greatest risk, say Italian researchers who reviewed available scientific literature.

Because many nations have aging populations, a growing number of people have both cancer and cardiovascular disease, the researchers said.

The review summarized the potential toxic effects of chemotherapeutic and chemopreventive drugs on the cardiovascular system. The researchers also stressed the importance of evaluating people’s cardiovascular risk before they have chemotherapy, called for new chemotherapy guidelines that include collateral effects on the cardiovascular system and recommended creation of a new interdisciplinary field of “cardio-oncology.”

Led by Adriana Albini, chief of oncology research at the Clinical and Research Institute Multimedica in Milan, the researchers said that using imaging techniques and biomarkers to identify high-risk patients would play an important role in reducing cardiovascular harm and death.

They also called for assessment of cardiotoxicity in phase 1 trials of new chemotherapy drugs that pose less heart risk.

“Today’s oncologists must be fully aware of cardiovascular risks to avoid or prevent adverse cardiovascular effects, and cardiologists must now be ready to assist oncologists by performing evaluations relevant to the choice of therapy,” the authors of the review wrote.