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Polypharmacy and medication regimen complexity as factors associated with hospital discharge destination among older people: a prospective cohort study
Wimmer, BC and Dent, E and Visvanathan, R and Wiese, MD and Johnell, K and Chapman, I and Bell, JS, Polypharmacy and medication regimen complexity as factors associated with hospital discharge destination among older people: a prospective cohort study, Drugs and Aging, 31, (8) pp. 623-630. ISSN 1170-229X (2014) [Refereed Article]
Copyright 2014 Springer International Publishing Switzerland
OBJECTIVE: To investigate the association between polypharmacy and medication regimen complexity with hospital discharge destination among older people.
METHODS: This prospective cohort study comprised patients aged ≥70 years consecutively admitted to the Geriatric Evaluation and Management unit at a tertiary hospital in Adelaide, Australia, between October 2010 and December 2011. Medication regimen complexity at discharge was calculated using the 65-item validated Medication Regimen Complexity Index (MRCI). Unadjusted and adjusted relative risks (RRs) with 95 % confidence intervals (CIs) were calculated for medication-related factors associated with discharge directly to home versus non-community settings (rehabilitation, transition care, and residential aged care).
RESULTS: From 163 eligible patients, 87 were discharged directly to home (mean age 84.6 years, standard deviation [SD] 6.9; mean MRCI 26.1, SD 9.7), while 76 were discharged to non-community settings (mean age 85.8 years, SD 5.8; mean MRCI 29.9, SD 13.2). After adjusting for age, sex, comorbidity, and activities of daily living, having a high medication regimen complexity (MRCI >35) was inversely associated with discharge directly to home (RR 0.39; 95 % CI 0.20-0.73), whereas polypharmacy (≥9 medications) was not significantly associated with discharge directly to home (RR 0.97; 95 % CI 0.53-1.58).
CONCLUSION: Having high medication regimen complexity was inversely associated with discharge directly to home, while polypharmacy was not associated with discharge destination.
|Item Type:||Refereed Article|
|Keywords:||medication regimen complexity, polypharmacy, aged, discharge destination|
|Research Division:||Biomedical and Clinical 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 health sciences|
|UTAS Author:||Wimmer, BC (Dr Barbara Wimmer)|
|Web of Science® Times Cited:||38|
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