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Medication-related risk factors and its association with repeated hospital admissions in frail elderly: A case control study
Cheong, V-Lin Sowter, Julie Scally, Andy J. Hamilton, N. Ali, A.
Cheong, V-Lin
Sowter, Julie
Scally, Andy J.
Hamilton, N.
Ali, A.
Publication Date
2020-09
End of Embargo
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Rights
© 2020 Elsevier. Reproduced in accordance with the publisher's self-archiving policy. This manuscript version is made available under the CC-BY-NC-ND 4.0 license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Peer-Reviewed
Yes
Open Access status
openAccess
openAccess
openAccess
Accepted for publication
2019-02-01
Institution
Department
Awarded
Embargo end date
Additional title
Abstract
Repeated hospital admissions are prevalent in older people. The role of medication in repeated hospital admissions has not been widely studied. The hypothesis that medication-related risk factors for initial hospital admissions were also associated with repeated hospital admissions was generated.
To examine the association between medication-related risk factors and repeated hospital admissions in older people living with frailty.
A retrospective case-control study was carried out with 200 patients aged ≥75 years with unplanned medical admissions into a large teaching hospital in England between January and December 2015. Demographic, clinical, and medication-related data were obtained from review of discharge summaries. Statistical comparisons were made between patients with 3 or more hospital admissions during the study period (cases) and those with 2 or fewer admissions (controls). Regressions were performed to establish independent predictors of repeated hospital admissions.
Participants had a mean age of 83.8 years (SD 5.68) and 65.5% were female. There were 561 admission episodes across the sample, with the main reasons for admissions recorded as respiratory problems (25%) and falls (17%). Univariate logistic regression revealed five medication-related risks to be associated with repeated hospital admissions: Hyper-polypharmacy (defined as taking ≥10 medications) (OR 2.50, p < 0.005); prescription of potentially inappropriate medications (PIMs) (OR 1.89; p < 0.05); prescription of a diuretic (OR 1.87; p < 0.05); number of high risk medication (OR 1.29; p < 0.05) and the number of 'when required' medication (OR 1.20; p < 0.05). However, the effects of these risk factors became insignificant when comorbid disease was adjusted for in a multivariable model.
Medication-related risk factors may play an important role in future repeated admission risk prediction models. The modifiable nature of medication-related risks factors highlights a real opportunity to improve health outcomes.
Version
Accepted manuscript
Citation
Cheong V-L, Sowter J, Scally AJ et al (2020) Medication-related risk factors and its association with repeated hospital admissions in frail elderly: A case control study. Research in Social and Administrative Pharmacy. 16(9): 1318-1322.
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Article