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http://hdl.handle.net/2440/95348
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Type: | Journal article |
Title: | Medication regimen complexity and unplanned hospital readmissions in older people |
Author: | Wimmer, B. Dent, E. Bell, J. Wiese, M. Chapman, I. Johnell, K. Visvanathan, R. |
Citation: | Annals of Pharmacotherapy, 2014; 48(9):1120-1128 |
Publisher: | SAGE |
Issue Date: | 2014 |
ISSN: | 1060-0280 1542-6270 |
Statement of Responsibility: | Barbara C. Wimmer, Elsa Dent, J. Simon Bell, Michael D. Wiese, Ian Chapman, Kristina Johnell, Renuka Visvanathan |
Abstract: | BACKGROUND: Medication-related problems and adverse drug events are leading causes of preventable hospitalizations. Few previous studies have investigated the possible association between medication regimen complexity and unplanned rehospitalization. OBJECTIVE: To investigate the association between discharge medication regimen complexity and unplanned rehospitalization over a 12-month period. METHOD: The prospective study comprised patients aged ≥70 years old consecutively admitted to a Geriatrics Evaluation and Management (GEM) unit between October 2010 and December 2011. Medication regimen complexity at discharge was calculated using the 65-item validated Medication Regimen Complexity Index (MRCI). Cox proportional-hazards regression was used to compute unadjusted and adjusted hazard ratios (HRs) with 95% CIs for factors associated with rehospitalization over a 12-month follow-up period. RESULT: Of 163 eligible patients, 99 patients had one or more unplanned hospital readmissions. When adjusting for age, sex, activities of daily living, depression, comorbidity, cognitive status, and discharge destination, MRCI (HR = 1.01; 95% CI = 0.81-1.26), number of discharge medications (HR = 1.01; 95% CI = 0.94-1.08), and polypharmacy (≥9 medications; HR = 1.12; 95% CI = 0.69-1.80) were not associated with rehospitalization. In patients discharged to nonhome settings, there was an association between rehospitalization and the number of discharge medications (HR = 1.12; 95% CI = 1.01-1.25) and polypharmacy (HR = 2.24; 95% CI = 1.02-4.94) but not between rehospitalization and MRCI (HR = 1.32; 95% CI = 0.98-1.78). CONCLUSION: Medication regimen complexity was not associated with unplanned hospital readmission in older people. However, in patients discharged to nonhome settings, the number of discharge medications and polypharmacy predicted rehospitalization. A patient's discharge destination is an important factor in unplanned medication-related readmissions. |
Keywords: | elderly; hospital readmission; medication regimen complexity |
Rights: | © The Author(s) 2014 |
RMID: | 0030013937 |
DOI: | 10.1177/1060028014537469 |
Appears in Collections: | Public Health publications |
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