Key result
Potentially inappropriate medications, polypharmacy, and anticholinergic burden at discharge were significantly associated with readmission and emergency room revisits within 6 months.
Why the study?
While certain drug-use indicators are associated with clinical outcomes, their relationship is unclear for some highly prevalent conditions in patients aged ≥65 years.
Do potentially inappropriate medications, polypharmacy, and anticholinergic burden increase the risk of readmission and emergency room revisits in older patients after discharge?
Cohort (n=3,061)
Do potentially inappropriate medications, polypharmacy, and anticholinergic burden increase the risk of readmission and emergency room revisits in older patients after discharge?
Potentially inappropriate medications, polypharmacy, and anticholinergic burden at discharge are associated with increased risk of readmission and emergency room revisits in older adults.
Drug-use indicators linked to readmissions/ER visits in older adults; leaves open whether targeting them improves outcomes.
AIMS: While certain drug-use indicators are known to be associated with clinical outcomes, the relationship is unclear for some highly prevalent conditions in in patients aged ≥65 years. We examine correlations between 3 drug-use indicators and postdischarge healthcare services use by older patients according to the presence of dementia, advanced age and frailty. METHODS: This retrospective cohort study analysed data collected from hospital electronic health records between April and December 2017. Potentially inappropriate medications (PIMs) and anticholinergic burden were assessed using the 2015 Beers Criteria and anticholinergic cognitive burden scale (ACBS) score. Minor and major polypharmacy were defined as the use of 5-9 and ≥10 drugs, respectively. Outcomes were set as emergency room revisits and readmissions at 1, 3 and 6 months postdischarge. The correlation between drug-use indicators and outcomes was analysed by multivariable logistic regression. RESULTS: The final cohort included 3061 patients for the analysis, and 2930, 2671 and 2560 patients were followed up to 1, 3 and 6 months after discharge. After controlling for confounders, all 3 drug-use indicators were significantly associated with readmission and emergency room revisits except for the relationship between PIMs and readmission within 6 months. These associations were significantly observed among patients without dementia, aged >80 years and with frailty. CONCLUSION: PIMs, polypharmacy and anticholinergic burden are common at discharge and correlate with future use of healthcare services. In older patients, the absence of dementia, advanced age and frailty should be given extra consideration with regard to medication safety.
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Liang et al. (2022) conducted a cohort in Older patients postdischarge (n=3,061). Potentially inappropriate medications, polypharmacy, and anticholinergic burden was evaluated on Emergency room revisits and readmissions at 1, 3 and 6 months postdischarge. Potentially inappropriate medications, polypharmacy, and anticholinergic burden at discharge were significantly associated with readmission and emergency room revisits within 6 months.
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