Risk factors of adverse health outcomes after hospital discharge modifiable by clinical pharmacist interventions: a review with a systematic approach

Morath, Benedict; Mayer, Tanja; Send, Alexander Francesco Josef; Hoppe-Tichy, Torsten; Haefeli, Walter E.; Seidling, Hanna M.

doi:10.1111/bcp.13318

Cited by 15 publications

(11 citation statements)

References 87 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A range of factors, for example, diabetes mellitus, obesity and polypharmacy, have been suggested to be risk factors for readmission (Morath et al . ). These are all more prevalent among people with ID than in the general population (e.g.…”

Section: Introductionmentioning

confidence: 97%

Hospital readmissions among older people with intellectual disability in comparison with the general population

Axmon

Björkman²,

Ahlström

2019

J intellect Disabil Res

View full text Add to dashboard Cite

BackgroundOlder people with intellectual disability have high multimorbidity and poor physical and mental health compared with the general population. Consequently, they have a greater need for health care. Hospital readmissions may be an indicator of the quality of health care. However, so far, only a few studies have investigated this outcome in populations of people with intellectual disability. None has focused on older people.MethodWe identified a cohort of people with intellectual disability aged 55+ years and alive at the end of 2012 (n = 7936). Moreover, we established a reference cohort from the general population, one‐to‐one matched by sex and year of birth. Data on hospital visits during the period 2002–2012 were collected from the Swedish National Patient Register. Readmissions were defined as unplanned visits with the same diagnosis occurring within 30 days of discharge and with no planned visit for the same diagnosis during this time.ResultsCompared with the general population, people with intellectual disability had increased risk of readmissions for diseases of the nervous system [relative risk (RR) 2.62], respiratory system (RR 1.48), digestive system (RR 1.40) and musculoskeletal system and connective tissue (RR 2.10). Within these diagnostic groups, increased risks were found for arthropathies (RR 3.73), disorders of gallbladder, biliary tract and pancreas (RR 1.78), other diseases of intestines (RR 1.30), and other forms of heart disease (RR 1.23). Decreased risk of readmissions was found for mental and behavioural disorders (RR 0.78) and diseases of the circulatory system (RR 0.64).ConclusionsThe increased risk for readmissions related to diseases of the nervous and musculoskeletal systems has a clear relation to the prevalence of comorbidities in these areas. People with intellectual disability often also have inborn limitations and damages in these systems which with time lead to complications and risk for diseases, which can be difficult to discover. The increased risk for readmissions for disease of the respiratory system, together with the already known increased prevalence of such diagnoses and their occurrence as a cause for death, warrants further investigations and considerations of potential preventive measures. The pattern of readmissions among older people with intellectual disability cannot be explained solely by a higher prevalence of disorders in this group. Our finding of increased risks for readmissions for diseases in the digestive system could be interpreted as communication problems, which sometimes result in too rapid discharges and their consequential early readmissions.

show abstract

Section: Introductionmentioning

confidence: 97%

Hospital readmissions among older people with intellectual disability in comparison with the general population

Axmon

Björkman²,

Ahlström

2019

J intellect Disabil Res

View full text Add to dashboard Cite

show abstract

“…10,16,17 Identifying and evaluating potentially modifiable risk factors for readmission, such as polypharmacy, is a focus of active investigation. 2,18,19 The role of polypharmacy as an independent risk factor predicting 30-day readmission is a recent debate. 20,21 Morandi et al studied the risk of readmission to elderly patients admitted to a rehabilitation facility and found that having a prescription of seven or more medications significantly increased the risk of hospital readmission within 30 days (hazard ratio (HR) 3.94; 95% confidence interval (CI) 1.62-9.54; p = 0.002).…”

Section: Introductionmentioning

confidence: 99%

Predictors of 30-day hospital readmission: The direct comparison of number of discharge medications to the HOSPITAL score and LACE index

Robinson

Bhattarai

Hudali

et al. 2019

Future Healthcare Journal

View full text Add to dashboard Cite

Effective hospital readmission risk prediction tools exist, but do not identify actionable items that could be modifi ed to reduce the risk of readmission. Polypharmacy has attracted attention as a potentially modifi able risk factor for readmission, showing promise in a retrospective study. Polypharmacy is a very complex issue, refl ecting comorbidities and healthcare resource utilisation patterns. This investigation compares the predictive ability of polypharmacy alone to the validated HOSPITAL score and LACE index readmission risk assessment tools for all adult admissions to an academic hospitalist service at a moderate sized university-affi liated hospital in the American Midwest over a 2-year period. These results indicate that the number of discharge medications alone is not a useful tool in identifying patients at high risk of hospital readmission within 30 days of discharge. Further research is needed to explore the impact of polypharmacy as a risk predictor for hospital readmission.

show abstract

“…Therefore, the community pharmacists can assess possible adverse events and inform prescribing doctors. 22,23 Interestingly, tracing reports submitted by the pharmacists who experienced face-to-face communication with the prescribing doctors did not signi cantly in uence to the deprescribing success rate, although a previous study mentioned that face-to-face communication with doctors is important for deprescribing. 24 This difference may have occurred because the past study did not perform a quantitative evaluation, whereas the present study did.…”

Section: Discussionmentioning

confidence: 90%

Searching for Success Factors in Deprescribing Proposals from Community Pharmacists

Osada¹

2021

Preprint

View full text Add to dashboard Cite

BackgroundPolypharmacy is one of the most critical issues worldwide, especially in elderly people. In Japan, fees to support deprescription were established in 2018 which are calculated as the community pharmacists propose deprescribing in patients prescribed 6 or more medications regularly by submitting documents to the prescribing doctor, who may withdraw 2 or more medications. However, these are hardly calculated though many deprescribing proposals submitted.ObjectiveThe objective in this study, success factors in deprescribing proposals from the community pharmacists to prescribing doctors were searched for.MethodsTracing reports submitted from Aug 2017 to Mar 2020 were investigated retrospectively and factors that influenced the success of deprescribing were searched for.ResultsOne hundred and twenty-three tracing reports (67 reports of successful deprescribing and 56 reports of failure, success rate was 54.5%) were submitted to the prescribing doctors. Deprescribing proposals with existing unused medications or an assessment of possible adverse events significantly increased the deprescribing success rate. Whether the pharmacist experienced face-to-face communication with the prescribing doctors was not significant.ConclusionTracing reports with deprescribing proposals submitted by the community pharmacists may resolve polypharmacy. Mentioning unused medications or possible adverse events could increase the deprescribing success rate.

show abstract

Risk factors of adverse health outcomes after hospital discharge modifiable by clinical pharmacist interventions: a review with a systematic approach

Cited by 15 publications

References 87 publications

Hospital readmissions among older people with intellectual disability in comparison with the general population

Hospital readmissions among older people with intellectual disability in comparison with the general population

Predictors of 30-day hospital readmission: The direct comparison of number of discharge medications to the HOSPITAL score and LACE index

Searching for Success Factors in Deprescribing Proposals from Community Pharmacists

Contact Info

Product

Resources

About