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Diabetic patients taking insulin run into trouble when their blood-sugar levels fall too low, he added. If they forget to eat or accidentally administer the wrong dose, they can pass out, fall and break a hip, he said. Its hard, often, to do the right thing every single time, Budnitz said. While medication safety has improved in hospitals, reducing harm from the medicines people take outside of the hospital remains a challenge, the study authors noted. Ninety percent of U.S. prescription spending occurs in outpatient settings, they said. Older patients often have multiple health conditions requiring complex medication regimens prescribed by different clinicians. This makes them particularly vulnerable, the study suggests. Illness such as diabetes and heart disease become more common with age and are treated with drugs commonly linked to emergency department visits, Budnitz explained. Also, having chronic illnesses can make adverse events more serious when they do occur, he said. Michael Cohen, president of the nonprofit Institute for Safe Medication Practices, said its important to document trends in adverse drug events.

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