Yes / 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.
| Identifer | oai:union.ndltd.org:BRADFORD/oai:bradscholars.brad.ac.uk:10454/17076 |
| Date | 14 February 2019 |
| Creators | Cheong, V-Lin, Sowter, Julie, Scally, Andy J., Hamilton, N., Ali, A., Silcock, Jonathan |
| Source Sets | Bradford Scholars |
| Language | English, English |
| Detected Language | English |
| Type | Article, Accepted manuscript |
| 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/), CC-BY-NC-ND, CC-BY-NC-ND |
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