Medication-related hospital admissions and readmissions in older patients: an overview of literature

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Abstract

Background The number of medication related hospital admissions and readmissions are increasing over the years due to the ageing population. Medication related hospital admissions and readmissions lead to decreased quality of life and high healthcare costs. Aim of the review To assess what is currently known about medication related hospital admissions, medication related hospital readmissions, their risk factors, and possible interventions which reduce medication related hospital readmissions. Method We searched PubMed for articles about the topic medication related hospital admissions and readmissions. Overall 54 studies were selected for the overview of literature. Results Between the different selected studies there was much heterogeneity in definitions for medication related admission and readmissions, in study population and the way studies were performed. Multiple risk factors are found in the studies for example: polypharmacy, comorbidities, therapy non adherence, cognitive impairment, depending living situation, high risk medications and higher age. Different interventions are studied to reduce the number of medication related readmission, some of these interventions may reduce the readmissions like the participation of a pharmacist, education programmes and transition-of-care interventions and the use of digital assistance in the form of Clinical Decision Support Systems. However the methods and the results of these interventions show heterogeneity in the different researches. Conclusion There is much heterogeneity in incidence and definitions for both medication related hospital admissions and readmissions. Some risk factors are known for medication related admissions and readmissions such as polypharmacy, older age and additional diseases. Known interventions that could possibly lead to a decrease in medication related hospital readmissions are spare being the involvement of a pharmacist, education programs and transition-care interventions the most mentioned ones although controversial results have been reported. More research is needed to gather more information on this topic.

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Most cited references 56

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We define an adverse drug reaction as "an appreciably harmful or unpleasant reaction, resulting from an intervention related to the use of a medicinal product, which predicts hazard from future administration and warrants prevention or specific treatment, or alteration of the dosage regimen, or withdrawal of the product." Such reactions are currently reported by use of WHO's Adverse Reaction Terminology, which will eventually become a subset of the International Classification of Diseases. Adverse drug reactions are classified into six types (with mnemonics): dose-related (Augmented), non-dose-related (Bizarre), dose-related and time-related (Chronic), time-related (Delayed), withdrawal (End of use), and failure of therapy (Failure). Timing, the pattern of illness, the results of investigations, and rechallenge can help attribute causality to a suspected adverse drug reaction. Management includes withdrawal of the drug if possible and specific treatment of its effects. Suspected adverse drug reactions should be reported. Surveillance methods can detect reactions and prove associations.

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Hospital admissions due to adverse drug reactions in the elderly. A meta-analysis.

T. J. Oscanoa, F. Lizaraso, Alfonso Carvajal (2017)

It is currently admitted that adverse drug reactions (ADRs) account for a great burden of disease. Of particular concern are ADR-induced hospital admissions, particularly in the elderly; they receive most of the medications and they are the most prone to develop ADRs. Therefore, our aim was to carry out a study of ADR-induced hospital admissions focused on the elderly population.

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Epidemiology of Adverse Drug Reactions in Europe: A Review of Recent Observational Studies

Jacoline Bouvy, Marie L. De Bruin, Marc Koopmanschap (2015)

Adverse drug reactions (ADRs) cause considerable mortality and morbidity but no recent reviews are currently available for the European region. Therefore, we performed a review of all epidemiological studies quantifying ADRs in a European setting that were published between 1 January 2000 and 3 September 2014. Included studies assessed the number of patients who were admitted to hospital due to an ADR, studies that assessed the number of patients who developed an ADR during hospitalization, and studies that measured ADRs in the outpatient setting. In total, 47 articles were included in the final review. The median percentage of hospital admissions due to an ADR was 3.5 %, based on 22 studies, and the median percentage of patients who experienced an ADR during hospitalization was 10.1 %, based on 13 studies. Only five studies were found that assessed ADRs occurring in the outpatient setting. These results indicate that the occurrence of ADRs in the European hospital setting—both ADRs that result in hospitalization and ADRs that occur during the hospital stay—is significant. Furthermore, the limited number of studies that were performed in the outpatient setting identify a lack of information regarding the epidemiology of ADRs in this setting.

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Author and article information

Contributors

A. E. M. J. H. Linkens:

ORCID: http://orcid.org/0000-0002-9252-7656

aimee.linkens@mumc.nl

Journal

Journal ID (nlm-ta): Int J Clin Pharm

Journal ID (iso-abbrev): Int J Clin Pharm

Title: International Journal of Clinical Pharmacy

Publisher: Springer International Publishing (Cham )

ISSN (Print): 2210-7703

ISSN (Electronic): 2210-7711

Publication date (Electronic): 30 May 2020

Publication date PMC-release: 30 May 2020

Publication date (Print): 2020

Volume: 42

Issue: 5

Pages: 1243-1251

Affiliations

[1 ]GRID grid.412966.e, ISNI 0000 0004 0480 1382, Department of Internal Medicine, , Maastricht University Medical Centre, ; PO Box 5800, 6202 AZ Maastricht, The Netherlands

[2 ]Department of Clinical Pharmacy, Pharmacology and Toxicology, Zuyderland Medical Centre, PO box 5500, 6130 MB Sittard, The Netherlands

[3 ]GRID grid.5645.2, ISNI 000000040459992X, Department of Clinical Pharmacy, , Erasmus Medical Centre, ; Postbus 2040, 3000 CA Rotterdam, The Netherlands

[4 ]Department of Internal Medicine, Zuyderland Medical Centre, PO box 5500, 6130 MB Sittard, Geleen, The Netherlands

[5 ]GRID grid.412966.e, ISNI 0000 0004 0480 1382, Department of Clinical Pharmacy, , Maastricht University Medical Centre, ; PO Box 5800, 6202 AZ Maastricht, The Netherlands

Author information

A. E. M. J. H. Linkens http://orcid.org/0000-0002-9252-7656

Article

Publisher ID: 1040

DOI: 10.1007/s11096-020-01040-1

PMC ID: 7522062

PubMed ID: 32472324

SO-VID: 968b5459-6a4c-4b69-8bed-892460c69842

License:

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