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    Medication-related risk factors and its association with repeated hospital admissions in frail elderly: A case control study

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    cheong_et_al_2019.pdf (263.5Kb)
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    Publication date
    2020-09
    Author
    Cheong, V-Lin
    Sowter, Julie
    Scally, Andy J.
    Hamilton, N.
    Ali, A.
    Silcock, Jonathan
    Keyword
    Medication risks
    Polypharmacy
    Inappropriate medication
    Prediction model
    Repeated hospital admissions
    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
    
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    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.
    URI
    http://hdl.handle.net/10454/17076
    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.
    Link to publisher’s version
    https://doi.org/10.1016/j.sapharm.2019.02.001
    Type
    Article
    Collections
    Life Sciences Publications
    Health Studies Publications

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