Premium
Hospital readmissions, mortality and potentially inappropriate prescribing: a retrospective study of older adults discharged from hospital
Author(s) -
Counter David,
Millar James W. T.,
McLay James S.
Publication year - 2018
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.13607
Subject(s) - medicine , medical prescription , logistic regression , demographics , emergency medicine , retrospective cohort study , multivariate analysis , polypharmacy , pediatrics , demography , sociology , pharmacology
Aims Applying version 2 of the STOPP/START criteria to discharge prescriptions of older adults discharged from a general medical unit, the aim of this study is to assess potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) and their association with hospital readmission and mortality. Methods Discharge medications, co‐morbidities and patient demographics were recorded over an 8‐month period for consecutive emergency admissions of patients aged ≥65 years. PIMs and PPOs were identified using version 2 of the STOPP/START criteria. Multivariate analysis for association of PIMs and PPOs with re‐admissions and mortality during the follow‐up period were assessed using binary logistic regression. Results Data for 259 patients with a mean age of 77 (65–99, 51% female) were analysed. At discharge, the mean number of co‐morbidities and medications per patient were 5.4 (SD: 2.1 range: 0–14) and 9.3 (SD: 4.0 range: 1–31) respectively. During the follow‐up period (mean 41.5 months, SD: 2.0 range: 38–46 months), 50.2% of patients had died and the median number of readmissions was two (IQR: 1–4 range: 0–33). Prescription of more than five medications was significantly associated with PIMs and PPOs (OR: 2.75, 95% CI: 1.34–5.62 and OR 3.20, 95% CI: 1.57–6.54 respectively). Presence of a PIM was associated with three or more readmissions (OR: 2.43 95% CI: 1.19–4.98) and PPOs with mortality (OR: 1.88, 95% CI: 1.09–3.27). Conclusions Using version 2 of the STOPP/START criteria, the presence of PIMs and/or PPOs in older adults discharged from hospital is significantly associated with repeated hospital admissions and mortality respectively.