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Medication regimen complexity and hospital readmission in older adults with chronic kidney disease

journal contribution
posted on 2023-05-19, 20:00 authored by Tesfaye, WH, Gregory PetersonGregory Peterson, Ronald CastelinoRonald Castelino, Charlotte McKercher, Matthew JoseMatthew Jose, Barbara Wimmer, Syed Razi ZaidiSyed Razi Zaidi

Background: Chronic kidney disease (CKD) is characterized by high rates of hospital admissions and readmissions. However, there is a scarcity of research into medication-related factors predicting such outcomes in this patient group.

Objective: To evaluate the effect of medication regimen complexity at hospital discharge on subsequent readmissions and their timing in older adults with CKD.

Methods: This was a 12-month retrospective cohort study of 204 older (⩾65 years) CKD patients in an Australian tertiary care hospital. Medication regimen complexity was quantified using the 65- item medication regimen complexity index (MRCI). The outcomes were the occurrence of readmission in 30 days and time to readmission within 12 months. Logistic regression was used to identify factors predicting 30-day readmission, and a competing risks proportional subdistribution hazard model, accounting for deaths, was used for factors predicting time to readmission.

Results: Overall, 50 (24%) patients, predominantly men (72%), were readmitted within 30 days of follow-up. MRCI was not significantly associated with 30-day readmission (odds ratio [OR] = 1.27; 95% CI = 0.94-1.73). The median (interquartile range) time to readmission within 12 months was 145 (31-365) days. On a multivariate analysis, a 10-unit increase in MRCI was associated with a shorter time to readmission within 12 months (subdistribution HR = 1.18; 95% CI = 1.01-1.36).

Conclusion and Relevance: Medication regimen complexity was not significantly associated with 30-day readmission; however, it was associated with a significantly shorter time to 12-month readmission in older CKD patients. This finding highlights the importance of medication regimen complexity as a potential target for medical interventions to reduce readmission risks.

History

Publication title

The Annals of Pharmacotherapy

Volume

53

Pagination

28-34

ISSN

1060-0280

Department/School

School of Pharmacy and Pharmacology

Publisher

Harvey Whitney Books Co

Place of publication

Po Box 42696, Cincinnati, USA, Oh, 45242

Rights statement

Copyright 2018 The Authors

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified; Health related to ageing