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Drug-related hospital visits in older patients: a post-hoc analysis of risk factors, preventability and causes in a randomized controlled trial.
Kempen, T.G., Hedman, A., Hadziosmanovic, N., Lindner, K.J., Nielsen, E.I., Melhus, H., Sulku, J., Gillespie, U. Drug-related hospital visits in older patients: a post-hoc analysis of risk factors, preventability and causes in a randomized controlled trial. International Journal of Clinical Pharmacy: 2022, 44(6), p. 1481. Conference abstract of the 50th ESCP Symposium on Clinical Pharmacy, Polypharmacy and ageing - highly individualized, interprofessional, person-centered care, 19–21 October 2022, Prague, Czech Republic
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ABSTRACT:
Background and Objective
Drug-related hospital visits in older patients are a major healthcare concern. There is a need to better
understand the risk factors for, and the underlying causes and preventability of drug-related visits. The aim of this study was to identify older patients’ risk factors for drug-related admissions (DRAs) and to
assess the preventability and causes of older patients’ DRAs and drugrelated emergency department (ED) visits.
Method
Post-hoc analysis of a randomized clinical trial in eight wards at four hospitals in Sweden. All 2637 trial participants, hospitalised patients aged 65 years or older, were included. To identify risk factors, a cox proportional hazards model was made with sociodemographic and clinical baseline characteristics. To assess preventability and causes, 400 trial participants were randomly selected. Patients’ hospital revisits (admissions and ED visits) within 12 months were assessed to identify preventable drug-related revisits.
Diseases and type of causes related to these revisits were then analysed with descriptive statistics.
Main outcome measures
The primary outcome for risk factor identification was DRA within 12 months post-discharge. The main outcomes for the assessment of preventability and causes were the percentage of preventable drug-related revisits, related diseases, and type of causes.
Results
Of all 2637 patients, median age (interquartile range) 81 (74–87) years, 582 (22%) experienced a DRA within 12 months. Fifteen risk factors (hazard ratio [1, p\ 0.05) related to age, previous hospital visits, number of medications, and cardiovascular, liver, lung and peptic ulcer disease were identified. The 400 randomly selected patients experienced a total of 522 hospital revisits of which 85 (16%) were preventable drug-related revisits. The two most prevalent diseases related to preventable revisits were heart failure
(n = 24, 28%) and COPD (n = 13, 15%). The two most prevalent type of causes were inadequate treatment (n = 23, 27.1%) and insufficient or no follow-up/monitoring (n = 22, 25.9%).
Conclusion
Risk factors for DRAs in older hospitalised patients
were related to age, previous hospital visits, medications, and cardiovascular, liver, lung and peptic ulcer disease. Drug-related hospital
Background and Objective
Drug-related hospital visits in older patients are a major healthcare concern. There is a need to better
understand the risk factors for, and the underlying causes and preventability of drug-related visits. The aim of this study was to identify older patients’ risk factors for drug-related admissions (DRAs) and to
assess the preventability and causes of older patients’ DRAs and drugrelated emergency department (ED) visits.
Method
Post-hoc analysis of a randomized clinical trial in eight wards at four hospitals in Sweden. All 2637 trial participants, hospitalised patients aged 65 years or older, were included. To identify risk factors, a cox proportional hazards model was made with sociodemographic and clinical baseline characteristics. To assess preventability and causes, 400 trial participants were randomly selected. Patients’ hospital revisits (admissions and ED visits) within 12 months were assessed to identify preventable drug-related revisits.
Diseases and type of causes related to these revisits were then analysed with descriptive statistics.
Main outcome measures
The primary outcome for risk factor identification was DRA within 12 months post-discharge. The main outcomes for the assessment of preventability and causes were the percentage of preventable drug-related revisits, related diseases, and type of causes.
Results
Of all 2637 patients, median age (interquartile range) 81 (74–87) years, 582 (22%) experienced a DRA within 12 months. Fifteen risk factors (hazard ratio [1, p\ 0.05) related to age, previous hospital visits, number of medications, and cardiovascular, liver, lung and peptic ulcer disease were identified. The 400 randomly selected patients experienced a total of 522 hospital revisits of which 85 (16%) were preventable drug-related revisits. The two most prevalent diseases related to preventable revisits were heart failure
(n = 24, 28%) and COPD (n = 13, 15%). The two most prevalent type of causes were inadequate treatment (n = 23, 27.1%) and insufficient or no follow-up/monitoring (n = 22, 25.9%).
Conclusion
Risk factors for DRAs in older hospitalised patients
were related to age, previous hospital visits, medications, and cardiovascular, liver, lung and peptic ulcer disease. Drug-related hospital
ABSTRACT:
Background and Objective
Drug-related hospital visits in older patients are a major healthcare concern. There is a need to better
understand the risk factors for, and the underlying causes and preventability of drug-related visits. The aim of this study was to identify older patients’ risk factors for drug-related admissions (DRAs) and to
assess the preventability and causes of older patients’ DRAs and drugrelated emergency department (ED) visits.
Method
Post-hoc analysis of a randomized clinical trial in eight wards at four hospitals in Sweden. All 2637 trial participants, hospitalised patients aged 65 years or older, were included. To identify risk factors, a cox proportional hazards model was made with sociodemographic and clinical baseline characteristics. To assess preventability and causes, 400 trial participants were randomly selected. Patients’ hospital revisits (admissions and ED visits) within 12 months were assessed to identify preventable drug-related revisits.
Diseases and type of causes related to these revisits were then analysed with descriptive statistics.
Main outcome measures
The primary outcome for risk factor identification was DRA within 12 months post-discharge. The main outcomes for the assessment of preventability and causes were the percentage of preventable drug-related revisits, related diseases, and type of causes.
Results
Of all 2637 patients, median age (interquartile range) 81 (74–87) years, 582 (22%) experienced a DRA within 12 months. Fifteen risk factors (hazard ratio [1, p\ 0.05) related to age, previous hospital visits, number of medications, and cardiovascular, liver, lung and peptic ulcer disease were identified. The 400 randomly selected patients experienced a total of 522 hospital revisits of which 85 (16%) were preventable drug-related revisits. The two most prevalent diseases related to preventable revisits were heart failure
(n = 24, 28%) and COPD (n = 13, 15%). The two most prevalent type of causes were inadequate treatment (n = 23, 27.1%) and insufficient or no follow-up/monitoring (n = 22, 25.9%).
Conclusion
Risk factors for DRAs in older hospitalised patients
were related to age, previous hospital visits, medications, and cardiovascular, liver, lung and peptic ulcer disease. Drug-related hospital
Background and Objective
Drug-related hospital visits in older patients are a major healthcare concern. There is a need to better
understand the risk factors for, and the underlying causes and preventability of drug-related visits. The aim of this study was to identify older patients’ risk factors for drug-related admissions (DRAs) and to
assess the preventability and causes of older patients’ DRAs and drugrelated emergency department (ED) visits.
Method
Post-hoc analysis of a randomized clinical trial in eight wards at four hospitals in Sweden. All 2637 trial participants, hospitalised patients aged 65 years or older, were included. To identify risk factors, a cox proportional hazards model was made with sociodemographic and clinical baseline characteristics. To assess preventability and causes, 400 trial participants were randomly selected. Patients’ hospital revisits (admissions and ED visits) within 12 months were assessed to identify preventable drug-related revisits.
Diseases and type of causes related to these revisits were then analysed with descriptive statistics.
Main outcome measures
The primary outcome for risk factor identification was DRA within 12 months post-discharge. The main outcomes for the assessment of preventability and causes were the percentage of preventable drug-related revisits, related diseases, and type of causes.
Results
Of all 2637 patients, median age (interquartile range) 81 (74–87) years, 582 (22%) experienced a DRA within 12 months. Fifteen risk factors (hazard ratio [1, p\ 0.05) related to age, previous hospital visits, number of medications, and cardiovascular, liver, lung and peptic ulcer disease were identified. The 400 randomly selected patients experienced a total of 522 hospital revisits of which 85 (16%) were preventable drug-related revisits. The two most prevalent diseases related to preventable revisits were heart failure
(n = 24, 28%) and COPD (n = 13, 15%). The two most prevalent type of causes were inadequate treatment (n = 23, 27.1%) and insufficient or no follow-up/monitoring (n = 22, 25.9%).
Conclusion
Risk factors for DRAs in older hospitalised patients
were related to age, previous hospital visits, medications, and cardiovascular, liver, lung and peptic ulcer disease. Drug-related hospital