Baena Díez J M, Griñó Guimerà A, San José Laporte A, Armadans Gil L, Selva O'Callaghan A, Vilardell Tarrès M
Unidad Docente de Medicina Familiar y Comunitaria, Universitat Autònoma de Barcelona.
Rev Clin Esp. 1997 Jul;197(7):472-8.
To evaluate the prevalence of comorbidity among elderly hospitalized patients and its influence on discharge diagnosis and medication due to non-exacerbated chronic disease (NECD). To evaluate the impact of hospital admission on the use of drugs due to NECD since admission to the month of discharge.
A study was made of 85 patients aged 65 years or older collected during two consecutive months. The study protocol consisted of a questionnaire on comorbidity, study of drug consume, discharge diagnosis and follow-up for one month post discharge.
Patients had a mean of 6.4 chronic diseases; significant differences were observed regarding discharge report (mean: 2.1). The number of drugs due to NECD prior to admission (mean: 2.9), at discharge (1.5) and one month after discharge (1.9) showed significant differences between those prior to admission, at discharge, and one month after discharge (p < 0.0001). Hospital admission involved a decrease (p < 0.0001) in the number of patients with polypharmacy criteria (more than four drugs), which persisted one month after discharge (p < 0.01), and in the prescription of polyvitaminic compounds, nonsteroid antiinflammatory drugs, antiaggregants, peripheral vasodilators and antacids (p < 0.03).
A relevant under-reporting of chronic diseases in the discharge report, particularly of those without exacerbations, as well as quantitative (decrease) and qualitative changes in the prescription due to NECD, maintained by the general practitioner one month after discharge. A higher awareness regarding chronic disease is necessary, as well as chronic disease is necessary, as well as establishing communication channels between Primary and Specialized Care.
