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Polypharmacy and medication regimen complexity as factors associated with hospital discharge destination among older people: a prospective cohort study

Citation

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 Statement

Copyright 2014 Springer International Publishing Switzerland

DOI: doi:10.1007/s40266-014-0185-1

Abstract

BACKGROUND: Older people often take multiple medications. It is a policy priority to facilitate older people to stay at home longer. Three-quarters of nursing home placements in the US are preceded by a hospitalization.

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 Details

Item Type:Refereed Article
Keywords:medication regimen complexity, polypharmacy, aged, discharge destination
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:106643
Year Published:2014
Web of Science® Times Cited:11
Deposited By:Pharmacy
Deposited On:2016-02-17
Last Modified:2017-11-02
Downloads:0

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