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Medication Regimen Complexity and Unplanned Hospital Readmissions in Older People

Citation

Wimmer, BC and Dent, E and Bell, JS and Wiese, MD and Chapman, I and Johnell, K and Visvanathan, R, Medication Regimen Complexity and Unplanned Hospital Readmissions in Older People, The Annals of Pharmacotherapy, 48, (9) pp. 1120-1128. ISSN 1060-0280 (2014) [Refereed Article]

Copyright Statement

The Author(s) 2014

DOI: doi:10.1177/1060028014537469

Abstract

BACKGROUND: Medication-related problems and adverse drug events are leading causes of preventable hospitalizations. Few previous studies have investigated the possible association between medication regimen complexity and unplanned rehospitalization.

OBJECTIVE: To investigate the association between discharge medication regimen complexity and unplanned rehospitalization over a 12-month period.

METHOD: The prospective study comprised patients aged ≥70 years old consecutively admitted to a Geriatrics Evaluation and Management (GEM) unit between October 2010 and December 2011. Medication regimen complexity at discharge was calculated using the 65-item validated Medication Regimen Complexity Index (MRCI). Cox proportional-hazards regression was used to compute unadjusted and adjusted hazard ratios (HRs) with 95% CIs for factors associated with rehospitalization over a 12-month follow-up period.

RESULT: Of 163 eligible patients, 99 patients had one or more unplanned hospital readmissions. When adjusting for age, sex, activities of daily living, depression, comorbidity, cognitive status, and discharge destination, MRCI (HR = 1.01; 95% CI = 0.81-1.26), number of discharge medications (HR = 1.01; 95% CI = 0.94-1.08), and polypharmacy (≥9 medications; HR = 1.12; 95% CI = 0.69-1.80) were not associated with rehospitalization. In patients discharged to nonhome settings, there was an association between rehospitalization and the number of discharge medications (HR = 1.12; 95% CI = 1.01-1.25) and polypharmacy (HR = 2.24; 95% CI = 1.02-4.94) but not between rehospitalization and MRCI (HR = 1.32; 95% CI = 0.98-1.78).

CONCLUSION: Medication regimen complexity was not associated with unplanned hospital readmission in older people. However, in patients discharged to nonhome settings, the number of discharge medications and polypharmacy predicted rehospitalization. A patient's discharge destination is an important factor in unplanned medication-related readmissions.

Item Details

Item Type:Refereed Article
Keywords:medication regimen complexity, hospital readmission, elderly
Research Division:Medical and Health Sciences
Research Group:Pharmacology and Pharmaceutical Sciences
Research Field:Clinical Pharmacy and Pharmacy Practice
Objective Division:Expanding Knowledge
Objective Group:Expanding Knowledge
Objective Field:Expanding Knowledge in the Medical and Health Sciences
Author:Wimmer, BC (Dr Barbara Wimmer)
ID Code:106641
Year Published:2014
Web of Science® Times Cited:13
Deposited By:Pharmacy
Deposited On:2016-02-17
Last Modified:2017-11-02
Downloads:0

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