Low and intermediate medication adherence at hospital admission was associated with higher odds of 30-day readmission compared to high adherence (OR 2.54; 95% CI 1.32-4.90; P=0.005).
Cohort (n=385)
Does low or intermediate medication adherence predict 30-day hospital readmission in inpatients?
Medication adherence assessed at hospital admission using the MMAS-4 is an independent predictor of 30-day readmission risk, improving predictive models.
Odds Ratio: 2.54 (95% CI 1.32–4.9)
Absolute Event Rate: 20% vs 9.3%
p-value: p=0.005
Purpose: The aim of this study was to test whether patient medication adherence, a modifiable risk factor obtainable at hospital admission, predicts readmission within 30 days. Patients and methods: We used a retrospective cohort study design to test whether patient medication adherence to all chronic medications, as determined by the 4-item Morisky Medication Adherence Scale (MMAS-4) administered by a pharmacist at the time of hospital admission, predicts 30-day readmissions. We compared readmission rates among 385 inpatients who had their adherence assessed from February 1, 2013, to January 31, 2014. Multiple logistic regression was used to examine the benefit of adding medication adherence to previously published variables that have been shown to predict 30-day readmissions. Results: Patients with low and intermediate adherence (combined) had readmission rates of 20.0% compared to a readmission rate of 9.3% for patients with high adherence ( P =0.005). By adding MMAS-4 data to previously published variables that have been shown to predict 30-day readmissions, we found that patients with low and intermediate medication adherence had an adjusted 2.54-fold higher odds of readmission compared to those in patients with high adherence (95% confidence interval CI: 1.32–4.90, P =0.005). The model’s predictive power, as measured by the c -statistic, improved from 0.65 to 0.70 after adding adherence. Conclusion: Because medication adherence assessed at hospital admission was independently associated with 30-day readmission risk, it offers potential for targeting interventions to improve adherence. Keywords: rehospitalization, predictive model, transition of care, care transitions, nonadherence, MMAS-4
Rosen et al. (Sat,) conducted a cohort in Hospital readmission (n=385). Low and intermediate medication adherence vs. High medication adherence was evaluated on 30-day readmission (OR 2.54, 95% CI 1.32-4.90, p=0.005). Low and intermediate medication adherence at hospital admission was associated with higher odds of 30-day readmission compared to high adherence (OR 2.54; 95% CI 1.32-4.90; P=0.005).
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