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Medication-Related Factors and Hospital Readmission in Older Adults with Chronic Kidney Disease

Citation

Tesfaye, WH and Peterson, GM and Castelino, RL and McKercher, C and Jose, M and Zaidi, STR and Wimmer, BC, Medication-Related Factors and Hospital Readmission in Older Adults with Chronic Kidney Disease, Journal of Clinical Medicine, 8 pp. 1-12. ISSN 2077-0383 (2019) [Refereed Article]


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Copyright 2019 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/

DOI: doi:10.3390/jcm8030395

Abstract

This study aimed to examine the association between medication-related factors and risk of hospital readmission in older patients with chronic kidney disease (CKD). A retrospective analysis was conducted targeting older CKD (n = 204) patients admitted to an Australian hospital. Medication appropriateness (Medication Appropriateness Index; MAI), medication regimen complexity (number of medications and Medication Regimen Complexity Index; MRCI) and use of selected medication classes were exposure variables. Outcomes were occurrence of readmission within 30 and 90 days, and time to readmission within 90 days. Logistic and Cox hazards regression were used to identify factors associated with readmission. Overall, 50 patients (24%) were readmitted within 30 days, while 81 (40%) were readmitted within 90 days. Mean time to readmission within 90 days was 66 (SD 34) days. Medication appropriateness and regimen complexity were not independently associated with 30- or 90-day hospital readmissions in older adults with CKD, whereas use of renin‒angiotensin blockers was associated with reduced occurrence of 30-day (adjusted OR 0.39; 95% CI 0.190.79) and 90-day readmissions (adjusted OR 0.45; 95% CI 0.240.84) and longer time to readmission within 90 days (adjusted HR 0.52; 95% CI 0.330.83). This finding highlights the importance of considering the potential benefits of individual medications during medication review in older CKD patients.

Item Details

Item Type:Refereed Article
Keywords:chronic kidney disease; medication appropriateness index; medication regimen complexity index; the elderly
Research Division:Medical and Health Sciences
Research Group:Pharmacology and Pharmaceutical Sciences
Research Field:Clinical Pharmacology and Therapeutics
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Urogenital System and Disorders
UTAS Author:Tesfaye, WH (Mr Wubshet Tesfaye)
UTAS Author:Peterson, GM (Professor Gregory Peterson)
UTAS Author:Castelino, RL (Dr Ronald Castelino)
UTAS Author:McKercher, C (Dr Charlotte McKercher)
UTAS Author:Jose, M (Professor Matthew Jose)
UTAS Author:Zaidi, STR (Dr Tabish Razi Zaidi)
UTAS Author:Wimmer, BC (Dr Barbara Wimmer)
ID Code:131566
Year Published:2019
Deposited By:Pharmacy
Deposited On:2019-03-22
Last Modified:2019-04-24
Downloads:12 View Download Statistics

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