Medication regimen complexity and unplanned hospital readmissions in older people

Wimmer, Barbara C., Dent, Elsa, Bell, J. Simon, Wiese, Michael D., Chapman, Ian, Johnell, Kristina and Visvanathan, Renuka (2014) Medication regimen complexity and unplanned hospital readmissions in older people. Annals of Pharmacotherapy, 48 9: 1120-1128. doi:10.1177/1060028014537469


Author Wimmer, Barbara C.
Dent, Elsa
Bell, J. Simon
Wiese, Michael D.
Chapman, Ian
Johnell, Kristina
Visvanathan, Renuka
Title Medication regimen complexity and unplanned hospital readmissions in older people
Journal name Annals of Pharmacotherapy   Check publisher's open access policy
ISSN 1542-6270
1060-0280
Publication date 2014-09-01
Sub-type Article (original research)
DOI 10.1177/1060028014537469
Open Access Status Not yet assessed
Volume 48
Issue 9
Start page 1120
End page 1128
Total pages 9
Place of publication Thousand Oaks, CA, United States
Publisher Sage Publications
Language eng
Formatted 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.
Keyword Elderly
Hospital readmission
Medication regimen complexity
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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