Medication-related problems associated with early hospital readmissions among hospice patients at a comprehensive cancer center in Jordan: a retrospective descriptive study

Early hospital readmissions among hospice patients are common and often indicate unresolved or rapidly evolving symptoms following discharge. Medication-related problems (MRPs) remain insufficiently characterized in hospice populations within the Middle East. This study assessed the prevalence and nature of MRPs contributing to early readmissions and compared medication and supportive-care patterns before and during readmission. A retrospective descriptive study reviewed readmissions among hospice patients within seven days of discharge over a one-year period at a comprehensive oncology center. MRPs were identified and classified using established clinical categories. Descriptive statistics were used to summarize medication adjustments and supportive-care interventions occurring in the pre-readmission interval and during subsequent hospitalization. Among 163 early readmissions, 30.7% were associated with MRPs. The leading contributors among MRP-related readmissions included insufficient dosing for symptom control (70%), uninitiated but clinically indicated medications (20%), and adherence challenges (14%); categories were not mutually exclusive. Pre-readmission medication changes were limited and predominantly oral, with frequent deprescribing of chronic therapies. In contrast, medication intensity increased markedly during hospitalization, including 367 additions, 283 discontinuations, and 100 dose adjustments, with 74.7% of the added medications delivered intravenously. Antimicrobials were the most frequently added class, while analgesics accounted for the most dose modifications. Supportive care escalated substantially during hospitalization, with increased use of intravenous hydration, oxygen therapy, transfusions, and invasive procedures. Medication-related problems were a common and potentially modifiable contributor to early hospice readmissions. Rapid symptom evolution and changing medication needs during transitions of care commonly precede clinical deterioration. Strengthening anticipatory medication planning, caregiver support, and flexibility in dosing and routes may help optimize symptom control and reduce avoidable readmissions within developing palliative care systems.