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Prevalence of medication-related admissions in older patients in Sweden and comparison to existing literature
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
2019 (English)Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
Abstract [en]

Medication-related problems (MRPs) are a common cause of hospital admissions in older patients. An ongoing trial known as Medication Reviews Bridging Healthcare (MedBridge) aims to study the effects of hospital-initiated comprehensive medication reviews on older patients’ healthcare utilisation, including the incidence of medicationrelated admissions (MRAs) during 12-month follow-up. Data on MRAs in Sweden is still limited and it is unknown if the prevalence is similar to that presented in other studies from around the globe. 

To assess the prevalence of MRAs among unplanned hospital readmissions in older patients in Sweden and to compare these results with existing international literature.

A literature search was performed to determine the prevalence of MRAs in the recent literature. The population in this study included MedBridge trial participants aged ≥ 65 years, who were readmitted to the hospitals of Uppsala, Gävle, Enköping or Västerås during their 12-month follow-up period. Admission and discharge notes, medication list and lab results in the patients’ electronic medical record were assessed independently by two final-year pharmacy students with a validated tool (AT-HARM10) to classify the readmissions as possibly or unlikely medicine-related. Probable MRAs were subclassified within the readmissions classified a possibly medicine-related. Consensus was sought on conflicting results. Secondary outcome measures were the prevalence of ICD10 diagnosis codes among all readmissions and the prevalence of medicine classes involved in probably MRAs. A two-tailed z-test for one proportion was used to compare the prevalence of MRAs with existing literature. A Chi2-test was used to compare the distribution of ICD-10 codes between all readmissions and those classified as possible MRAs.

Out of the 1687 readmissions assessed in this study, 25 % (95 %-confidence interval: 23-27 %) were classified as possibly medicine-related, which was higher than the 21 % found in the literature. Eight percent of all readmissions were sub-classified as probably medicine-related. The most common ICD-10 codes among readmissions classified as possible MRAs were circulatory problems (35 %), respiratory problems (14 %) and endocrine problems (9 %), which differed from all readmissions. The most common medicine classes involved were antithrombotic agents (20 %), diuretics (10 %), antidiabetics (10 %) as well as issues concerning multiple medicines (27 %).

The prevalence of MRAs among unplanned hospital readmissions in older patients in Sweden is 25 %, which seems to be higher than the prevalence in existing literature. 

Place, publisher, year, edition, pages
2019. , p. 25
Keywords [en]
clinical pharamcy medbridge medication related hospital readmissions elderly patients hospitals
National Category
Social and Clinical Pharmacy
Identifiers
URN: urn:nbn:se:uu:diva-391092OAI: oai:DiVA.org:uu-391092DiVA, id: diva2:1343716
Subject / course
Pharmacotherapy
Educational program
Master of Science Programme in Pharmacy
Presentation
2019-06-03, Uppsala biomedicinska centrum (BMC), Husargatan 3, 751 23 Uppsala, Uppsala, 10:59 (Swedish)
Supervisors
Examiners
Available from: 2019-09-17 Created: 2019-08-19 Last updated: 2019-09-17Bibliographically approved

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