Evaluation of Drug-Disease Interactions and Their Association with Unplanned Hospital Readmission Utilizing STOPP Version 2 Criteria

Abstract

Abstract:Early hospital readmission is a common problem among geriatric patients, as they are more susceptible to adverse drug events, which are associated with increased hospital admission. The objective is to examine the association between exposure to potentially inappropriate medications under selected STOPP version 2 criteria related to drug-disease interactions and unplanned early hospitalization within 28 days of index admission in elderly patients prescribed a potentially inappropriate medication. This retrospective single-center study reviewed patients 75 years of age or older that were discharged with 5 or more medications, including at least one selected medication listed in the STOPP version 2 criteria relating to drug-disease interactions. 182 patients, with a mean age of 83.5 years, were included in the study, with anticholinergics being the most common potentially inappropriate medications (22.4%). Potentially inappropriate medications (57.1% vs. 17.1%, p < 0.001), gout (31% vs. 11.5%, p = 0.003), and gastrointestinal disease (11.9% vs. 2.5%, p = 0.026) were shown to increase risk of 28-day readmission, whereas no other factors assessed correlated with readmission. A rapid evaluation of elderly patient discharge medications and concomitant disease states with the aid of the STOPP version 2 criteria could potentially reduce hospital readmissions or emergency department visits.

Prevalence of potentially inappropriate prescribing in older people in primary care and its association with hospital admission: longitudinal study

“… 22 Other observational studies have found consistent associations between the STOPP criteria and avoidable adverse drug events relevant to the index admission among hospital inpatients, 12 poorer quality of life, 14 emergency department visits, 14 15 and unplanned readmission to hospital. 23 Prescribing included in STOPP was considered causal in 30% of adverse drug reactions in a Swedish study in an older population, 24 and in a study of definitely or possibly avoidable adverse drug events that led to hospital admission, 62.2% were listed in the STOPP criteria. 12 On this basis, the STOPP criteria can be considered a valid process measure of quality of care, and they have been used as primary outcomes in interventional trials aiming to improve prescribing.…”

Potentially inappropriate prescribing and its associations with health‐related and system‐related outcomes in hospitalised older adults: A systematic review and meta‐analysis

“…106 Also, it is debatable whether the health outcomes are due to the PIPs or the disease/condition itself. Several studies 38,62,68,69,76,79,84,86,87 failed to adjust for comorbidities. The heterogeneity in adjustment may be 1 of the factors why pooled estimates from the adjusted vs. unadjusted model vary in the magnitude/direction of effect, specifically for the outcome related to hospital readmissions.…”

Adverse drug event of hypokalaemia‐induced cardiotoxicity secondary to the use of laxatives: A systematic review of case reports

“…The coexisting medical condition of a patient has been shown to be associated with adverse drug events due to drug‐disease interaction 51 . For instance, the past/coexisting diseases of the cardiac system make the heart prone to the adverse hypokalaemic event 52 .…”