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https://hdl.handle.net/2440/95346
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Type: | Journal article |
Title: | Polypharmacy and medication regimen complexity as factors associated with hospital discharge destination among older people: a prospective cohort study |
Author: | Wimmer, B. Dent, E. Visvanathan, R. Wiese, M. Johnell, K. Chapman, I. Bell, J. |
Citation: | Drugs and Aging, 2014; 31(8):623-630 |
Publisher: | Springer International Publishing |
Issue Date: | 2014 |
ISSN: | 1170-229X 1179-1969 |
Statement of Responsibility: | Barbara Caecilia Wimmer, Elsa Dent, Renuka Visvanathan, Michael David Wiese, Kristina Johnell, Ian Chapman, J. Simon Bell |
Abstract: | BACKGROUND: Older people often take multiple medications. It is a policy priority to facilitate older people to stay at home longer. Three-quarters of nursing home placements in the US are preceded by a hospitalization. OBJECTIVE: To investigate the association between polypharmacy and medication regimen complexity with hospital discharge destination among older people. METHODS: This prospective cohort study comprised patients aged ≥70 years consecutively admitted to the Geriatric Evaluation and Management unit at a tertiary hospital in Adelaide, Australia, between October 2010 and December 2011. Medication regimen complexity at discharge was calculated using the 65-item validated Medication Regimen Complexity Index (MRCI). Unadjusted and adjusted relative risks (RRs) with 95 % confidence intervals (CIs) were calculated for medication-related factors associated with discharge directly to home versus non-community settings (rehabilitation, transition care, and residential aged care). RESULTS: From 163 eligible patients, 87 were discharged directly to home (mean age 84.6 years, standard deviation [SD] 6.9; mean MRCI 26.1, SD 9.7), while 76 were discharged to non-community settings (mean age 85.8 years, SD 5.8; mean MRCI 29.9, SD 13.2). After adjusting for age, sex, comorbidity, and activities of daily living, having a high medication regimen complexity (MRCI >35) was inversely associated with discharge directly to home (RR 0.39; 95 % CI 0.20-0.73), whereas polypharmacy (≥9 medications) was not significantly associated with discharge directly to home (RR 0.97; 95 % CI 0.53-1.58). CONCLUSION: Having high medication regimen complexity was inversely associated with discharge directly to home, while polypharmacy was not associated with discharge destination. |
Keywords: | Humans Pharmaceutical Preparations Patient Discharge Cohort Studies Prospective Studies Decision Trees Aged Aged, 80 and over Health Services for the Aged Australia Female Male Outcome Assessment, Health Care |
Rights: | © Springer International Publishing Switzerland 2014 |
DOI: | 10.1007/s40266-014-0185-1 |
Published version: | http://dx.doi.org/10.1007/s40266-014-0185-1 |
Appears in Collections: | Aurora harvest 3 Public Health publications |
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