TY - JOUR
T1 - Medication regimen complexity and unplanned hospital readmissions in older people
AU - Wimmer, Barbara
AU - Dent, Elsa
AU - Bell, John Simon Frederick
AU - Wiese, Michael
AU - Chapman, Ian
AU - Johnell, Kristina
AU - Visvanathan, Renuka
PY - 2014
Y1 - 2014
N2 - 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.
AB - 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.
UR - http://aop.sagepub.com/content/48/9/1120.full.pdf+html
U2 - 10.1177/1060028014537469
DO - 10.1177/1060028014537469
M3 - Article
VL - 48
SP - 1120
EP - 1128
JO - Annals of Pharmacotherapy
JF - Annals of Pharmacotherapy
SN - 1060-0280
IS - 9
ER -