Medication‐related hospital admissions in aged care residents

Ellett, Lisa M. Kalisch; Kassie, Gizat M.; Caughey, Gillian E.; Pratt, Nicole; Ramsay, Emmae; Roughead, Elizabeth E.

doi:10.1111/ajag.12975

Cited by 4 publications

(4 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recent studies have also observed higher preventability: 60.9% ( Li et al, 2021 ) 42.9% ( Dechanont et al, 2021 ), 53.5% ( Maříková et al, 2021 ), 46% ( Kalisch Ellett et al, 2021 ) 47% ( Lombardi et al, 2020 ), 76.4% ( Cabre et al, 2018 ) 69% ( Giardina et al, 2018 ). However, most of them were limited to older patients, in whom the preventability is higher than in the general population.…”

Section: Discussionmentioning

confidence: 93%

“…In a study in Belgium ( Somers et al, 2010 ), the most common symptom associated with drug therapy failures was dyspnea. A study from Australia ( Kalisch Ellett et al, 2021 ) identified that chronic heart failure and osteoporosis were most frequently associated with potentially suboptimal medication-related processes of care related to the underuse of medications. However, there are not many studies that focus not only on DRAs related to treatment safety but also on DRAs related to treatment effectiveness.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Drug-Related Hospital Admissions via the Department of Emergency Medicine: A Cross-Sectional Study From the Czech Republic

2022

View full text Add to dashboard Cite

Background: Drug-related hospital admissions (DRAs) represent a significant problem affecting all countries worldwide. This study aimed to determine the prevalence and preventability of DRAs, identify the most common medications involved in DRAs, the most common clinical manifestations of DRAs and describe the preventability aspects of DRAs.Methods: This cross-sectional study examined unplanned hospital admissions to the University Hospital Hradec Králové via the department of emergency medicine in August–November 2018. Data were obtained from electronic medical records. The methodology of DRA identification was adapted from the OPERAM DRA adjudication guide.Results: Out of 1252 hospital admissions, 195 DRAs have been identified (145 related to treatment safety, 50 related to treatment effectiveness). The prevalence of DRAs was 15.6% (95% CI 13.6–17.6). The most common medication classes involved in DRAs related to treatment safety were Antithrombotic agents, Antineoplastic agents, Diuretics, Corticosteroids for systemic use, and Beta blocking agents. The most common medication classes involved in DRAs related to treatment effectiveness included Diuretics, Antithrombotic agents, Drugs used in diabetes, Agents acting on the renin-angiotensin system, and Lipid modifying agents. Gastrointestinal disorders were the leading causes of DRAs related to treatment safety, while Cardiac disorders were the leading causes of DRAs related to treatment effectiveness. The potential preventability of DRAs was 51%. The highest share of potential preventability in medication classes repeatedly involved in DRAs related to treatment safety was observed for Anti-inflammatory and antirheumatic products, Psycholeptics, and Drugs used in diabetes. Potentially preventable DRAs related to treatment safety were most commonly associated with inappropriate drug selection, inappropriate monitoring, inappropriate dose selection, and inappropriate lifestyle measures. On the contrary, DRAs related to treatment effectiveness were more commonly associated with medication nonadherence.Conclusion: It should be emphasized that in most DRAs, medications were only a contributory reason of hospital admissions and that benefits and risks have to be carefully balanced. It is highlighted by the finding that the same medication classes (Antithrombotic agents and Diuretics) were among the most common medication classes involved in DRAs related to treatment safety and simultaneously in DRAs related to treatment effectiveness. The study highlighted that apart from problems related to prescribing, problems related to monitoring and patient-related problems represent significant preventability aspects.

show abstract

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Drug-Related Hospital Admissions via the Department of Emergency Medicine: A Cross-Sectional Study From the Czech Republic

2022

View full text Add to dashboard Cite

show abstract

“…Around one in five hospitalizations among older Australians are medicines‐related 9 . Similarly, a previous study in Australia reported that 46% of the hospitalizations among older residents were due to potentially suboptimal use of medicines 11 . In addition, many aged care residents were on fall‐risk drugs and visited hospital with fractures.…”

Section: Introductionmentioning

confidence: 97%

“…Similarly, a previous study in Australia reported that 46% of the hospitalizations among older residents were due to potentially suboptimal use of medicines. 11 In addition, many aged care residents were on fall‐risk drugs and visited hospital with fractures. Discontinuation or dose reduction in fall‐risk drugs significantly reduces the occurrence of falls in older people.…”

Section: Introductionmentioning

confidence: 99%

Exploring Australian pharmacists' views toward reducing the risk of medicines‐related harm in aged care residents

Curtain

Peterson

Salahudeen

2023

Pharmacology Res & Perspec

View full text Add to dashboard Cite

Medicines‐related harm is common in older people living in residential aged care facilities (RACFs). Pharmacists offering services in the aged care sector may play a key role in reducing medicines‐related injury. This study aimed to explore Australian pharmacists' views toward reducing the risk of medicines‐related harm in older residents. Qualitative, semi‐structured interviews were conducted with 15 Pharmacists across Australia providing services (e.g., through the provision of medication reviews, supplying medications, or being an embedded pharmacist) to RACFs identified via convenience sampling. Data were analyzed by thematic analysis using an inductive approach. Medicines‐related harm was thought to occur due to polypharmacy, inappropriate medicines, anticholinergic activity, sedative load, and lack of reconciliation of medicines. Pharmacists reported that strong relationships, education of all stakeholders, and funding for pharmacists were facilitators in reducing medicines‐related harm. Pharmacists stated that renal impairment, frailty, staff non‐engagement, staff burnout, family pressure, and underfunding were barriers to reducing medicines‐related harm. Additionally, the participants suggested pharmacist education, experience, and mentoring improve aged care interactions. Pharmacists believed that the irrational use of medicines increases harm in aged care residents, and medicines‐specific (e.g., sedative load) and patient‐specific risk factors (e.g., renal impairment) are associated with injuries in residents. To reduce medicines‐related harm, the participants highlighted the need for increased funding for pharmacists, improving all stakeholders' awareness about medicines‐associated harms through education, and ensuring collaboration between healthcare professionals caring for older residents.

show abstract

Residential medication management reviews: a call for improved collaboration and systems integration in aged care

Richardson,

Payne,

Richardson

et al. 2024

WWOP

View full text Add to dashboard Cite

Purpose Residential Medication Management Reviews (RMMR) are a key component of safe, high-quality aged care service delivery. The RMMR is an interdisciplinary approach to medication management that relies on collaboration, communication and integration of systems. Acting as an improvement opportunity, the purpose of this paper is to present findings from a regional study, aimed at assessing the impact of RMMR on falls and hospital admissions and identifies barriers to impactful research in this area. Design/methodology/approach A three-year retrospective quantitative longitudinal practice audit was conducted in a regional state-managed high-care residential facility in Queensland, Australia. Data was collected pre-RMMR and six months post-RMMR. Findings The data collected was insufficient to achieve statistical significance or demonstrate the impact of RMMR on health outcomes. Factors impeding the research included limited ability to collect the data due to the lack of integration of information systems and limited stakeholder engagement resulting in poor recruitment. This highlights the need for improvement in RMMR processes and practices, and indeed wider research collaboration in the aged care sector. Research limitations/implications Thís paper acts as a call to action to improve research and interprofessional collaboration in Australian aged care. Originality/value The aged care industry needs high-quality research to drive practice improvement and collaborative care and service delivery. This paper advocates for improvements in the aged care sector with respect to research engagement and communication pathways between service providers. Advancement in systems integration for information sharing, recruitment of participants and stakeholder engagement will support evidence-based practice and process change.

show abstract

Medication‐related hospital admissions in aged care residents

Cited by 4 publications

References 27 publications

Drug-Related Hospital Admissions via the Department of Emergency Medicine: A Cross-Sectional Study From the Czech Republic

Drug-Related Hospital Admissions via the Department of Emergency Medicine: A Cross-Sectional Study From the Czech Republic

Exploring Australian pharmacists' views toward reducing the risk of medicines‐related harm in aged care residents

Residential medication management reviews: a call for improved collaboration and systems integration in aged care

Contact Info

Product

Resources

About