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August 23, 2011JAMA

Association of ICU or Hospital Admission With Unintentional Discontinuation of Medications for Chronic Diseases

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Why the study?

Does hospital or ICU admission increase the risk of unintentional discontinuation of chronic medications in older adults?

Population

396,380 patients aged 66 years or older with continuous use of at least 1 of 5 evidence-based medication…

Comparison

Admission to the intensive care unit or… vs Nonhospitalized patients (controls)

Design

Cohort

Follow-up

90 days for primary outcome, 1 year for secondary outcome

Authors

CBChaim M. BellUniversity of VermontSBStacey BrenerUniversity of TorontoNGNadia GunrajToronto Public Health

Discussion

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Implication

ICU admission may signal heightened discontinuation risk in older adults; hypothesis-generating for continuity interventions pending prospective trials.

Structured PICO

Does hospital or ICU admission increase the risk of unintentional discontinuation of chronic medications in older adults?

P
Population
396,380 patients aged 66 years or older with continuous use of at least 1 of 5 evidence-based medication groups prescribed for long-term use (statins, antiplatelet/anticoagulant agents, levothyroxine, respiratory inhalers, and gastric acid-suppressing drugs) in Ontario, Canada.
I
Intervention
Admission to the intensive care unit (ICU) or hospitalization without ICU admission
C
Comparator
Nonhospitalized patients (controls)
O
Outcome
Failure to renew the prescription within 90 days after hospital discharge

Hospital and ICU admissions are associated with a significantly increased risk of unintentional discontinuation of chronic evidence-based medications in older adults, which is linked to adverse clinical outcomes.

Cite This Study

Bell et al. (2011) studied this question.

synapsesocial.com/papers/6a726719439bab0cabc3d6behttps://doi.org/10.1001/jama.2011.1206

Topics

Heart failure hospitalization
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