Half of medication-related harm in discharged patients is preventable
Harm from medicines occurs in one in three older patients following discharge, 50 percent of which is preventable. Findings were published May 22 in the British Journal of Clinical Pharmacology.
Patients who have recently been discharged are the most likely to experience medication‐related harm (MRH) due to medication changes and poor data transfer between hospitals and primary care providers. In this study, researchers from the University of Southampton, Brighton and Sussex Medical School and others examined the incidence, severity, preventability and costs of MRH in older adults in England following discharge.
The study enrolled 1,280 patients from five teaching hospitals in Southern England. Participants were monitored for eight weeks by senior pharmacists who conducted hospital readmission reviews, telephone interviews and reviews of primary care records to identify MRH.
Results showed 37 percent of participants experienced MRH, with 556 MRH incidents per 1,000 discharges. Researchers noted 81 percent of MRH incidents were serious, 52 percent were potentially preventable, and four participants experienced deadly MRH. Individuals who were prescribed opiates, antibiotics, and benzodiazepines were at the highest risk of developing MRH. Gastrointestinal (25 percent) and neurological (18 percent) incidents were the most common forms of MRH.
Following MRH, 79 percent of participants sought care which led to hospital readmissions. In all, this happened in 78 per 1,000 discharges. MRH in older adults was measured to have cost £396 million a year, 90 percent of which was attributed to hospital readmissions.
"As the use of medicines in the aging population is rapidly increasing, it's vital that we improve awareness among clinicians of the harm that medicines commonly cause," said Prof. Chakravarthi Rajkumar, senior investigator and Chair of Geriatrics and Stroke Medicine at Brighton and Sussex Medical School in the U.K. "The risk-to-benefit analysis is particularly complex in the older population. Any decision to prescribe medicines should be made in close collaboration with patients and careers, with a tentative stop date and with monitoring of correct usage and adverse reactions."