Abstract
Previous studies have shown that approximately 20% of hospital readmissions can be medication-related and 70% of these readmissions are possibly preventable. This retrospective medical records study aimed to find risk factors associated with medication-related readmissions to hospital within 30 days of discharge in older adults (≥65 years). 30-day readmissions (n = 360) were assessed as being either possibly or unlikely medication-related after which selected variables were used to individually compare the two groups to a comparison group (n = 360). The aim was to find individual risk factors of possibly medication-related readmissions focusing on living arrangements, polypharmacy, potentially inappropriate medication therapy, and changes made to medication regimens at initial discharge. A total of 143 of the 360 readmissions (40%) were assessed as being possibly medication-related. Charlson Comorbidity Index (OR 1.15, 95%CI 1.5-1.25), excessive polypharmacy (OR 1.74, 95%CI 1.07-2.81), having adjustments made to medication dosages at initial discharge (OR 1.63, 95%CI 1.03-2.58) and living in your own home, alone, were variables identified as risk factors of such readmissions. Living in your own home, alone, increased the odds of a possibly medication-related readmission 1.69 times compared to living in your own home with someone (p-value 0.025) and 2.22 times compared to living in a nursing home (p-value 0.037). Possibly medication-related readmissions within 30 days of discharge, in patients 65 years and older, are common. The odds of such readmissions increase in comorbid, highly medicated patients living in their own home, alone, and if having medication dosages adjusted at initial discharge. These results indicate that care planning before discharge and the provision of help with, for example, managing medications after discharge, are factors especially important if aiming to reduce the amount of medication-related readmissions among this population. Further research is needed to confirm this hypothesis.
Highlights
Readmission to hospital within 30 days of discharge is common [1,2,3,4] especially in older adults [2] where hospitalisation pose a great risk as it could lead to consequences such as infectious disease, confusion, and risk of falling [5]
Charlson Comorbidity Index, excessive polypharmacy, having adjustments made to medication dosages at initial discharge and living in your own home, alone, were variables identified as risk factors of such readmissions
Living in your own home, alone, increased the odds of a possibly medication-related readmission 1.69 times compared to living in your own home with someone (p-value 0.025) and 2.22 times compared to living in a nursing home (p-value 0.037)
Summary
Readmission to hospital within 30 days of discharge is common [1,2,3,4] especially in older adults [2] where hospitalisation pose a great risk as it could lead to consequences such as infectious disease, confusion, and risk of falling [5]. Older adults often suffer from several comorbidities leading to the use of multiple medications, both known risk factors concerning hospital readmission within 30 days of discharge [8,9]. This increased risk may be due to polypharmacy increasing the risk of medication errors [10] and medication-related problems such as adverse drug reactions [11] or drug-drug interactions [11,12]. This retrospective medical records study aimed to find risk factors associated with medication-related readmissions to hospital within 30 days of discharge in older adults ( 65 years)
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