Clinical Interventions in Aging (Nov 2019)
Relationship Between Potentially Inappropriate Medications And The Risk Of Hospital Readmission And Death In Hospitalized Older Patients
Abstract
Peng Wang,1 Qing Wang,1 Fang Li,1 Meng Bian,2 Kun Yang3 1Department of Geriatrics, Fuxing Hospital, The Eighth Clinical Medical College, Capital Medical University, Beijing, People’s Republic of China; 2Department of Pharmacy, Fuxing Hospital, The Eighth Clinical Medical College, Capital Medical University, Beijing, People’s Republic of China; 3Centre for Evidence-Based Medicine, Xuanwu Hospital Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Qing WangDepartment of Geriatrics, Fuxing Hospital, The Eighth Clinical Medical College, Capital Medical University, 14 Fuwai street, Beijing 100038, People’s Republic of ChinaEmail [email protected]: This study aimed to compare the prevalence of potentially inappropriate medications (PIMs) among hospitalized elderly patients using Beers and Chinese criteria and identify the correlation between PIMs and the risk of hospital readmission and death.Methods: This study was conducted on geriatric patients aged ≥65 years at Beijing Fuxing Hospital between June 2015 and December 2017. The Beers criteria of 2015 and the Chinese criteria of 2017 were used to detect PIMs. Follow-ups were conducted for 12–36 months (or until patients’ death, if it came sooner). Cox proportional-hazards models were used to explore the correlations between PIM use and the risk of hospital readmission and death.Results: Of 508 patients, 352 (69.3%) and 339 (66.7%) had at least one PIM identified using the Beers criteria and the Chinese criteria, respectively. Proton-pump inhibitors in the Beers criteria and clopidogrel in the Chinese criteria were the most leading PIMs. PIMs identified using the Beers criteria were a risk factor for the all-cause hospital readmission. After adjusting for age, gender, comorbidity, and so forth, PIM use was still an indicator of rehospitalization. PIM grouping defined using the Chinese criteria was not associated with hospital readmission. PIM grouping defined using either criteria was not associated with all-cause death.Conclusion: The study showed a high prevalence of PIM use in China. PIMs defined using the Beers criteria increased the risk of hospital readmission. Clinicians should pay more attention to PIMs, carry out routine PIM assessment, and reduce adverse health outcomes in elderly patients.Keywords: Beers criteria, Chinese criteria, death, elderly, potentially inappropriate medication, readmission
