Department of Clinical Sciences Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden.
Department of Medications, Region Skåne Office for Hospitals in Northeastern Skåne, Kristianstad, Sweden.
PLoS One. 2021 Jun 10;16(6):e0253024. doi: 10.1371/journal.pone.0253024. eCollection 2021.
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.
先前的研究表明，约 20%的医院再入院与药物相关，其中 70%可能是可以预防的。本回顾性病历研究旨在发现与老年人（≥65 岁）出院后 30 天内药物相关再入院相关的危险因素。
评估 30 天再入院（n=360）是否可能与药物相关，然后选择变量单独将两组与对照组（n=360）进行比较。目的是发现可能与药物相关的再入院的个体危险因素，重点关注居住安排、多种药物治疗、潜在不适当的药物治疗以及初始出院时药物治疗方案的改变。
360 例再入院中，共有 143 例（40%）被评估为可能与药物相关。Charlson 合并症指数（OR 1.15，95%CI 1.5-1.25）、过度多种药物治疗（OR 1.74，95%CI 1.07-2.81）、初始出院时药物剂量调整（OR 1.63，95%CI 1.03-2.58）和独自居住在自己家中是确定此类再入院危险因素的变量。与与他人居住在自己家中（p 值 0.025）相比，独自居住在自己家中的可能性药物相关再入院的可能性增加了 1.69 倍，与居住在养老院（p 值 0.037）相比增加了 2.22 倍。
65 岁及以上患者出院后 30 天内可能发生药物相关再入院，较为常见。患有合并症、接受高度药物治疗的患者独自居住在自己家中，且初始出院时调整药物剂量，发生此类再入院的可能性增加。这些结果表明，在出院前进行护理计划以及提供帮助，例如管理出院后的药物，对于减少该人群中与药物相关的再入院数量尤为重要。需要进一步研究来证实这一假设。
