What drives medication-related readmissions?

Hospital readmission due to medications are common, especially in older patients, a recent study has found. Comorbid, highly medicated patients who live alone are also at excess risk of medication-related readmissions.

Researchers retrospectively looked at 360 patients who were readmitted within 30 days for reasons deemed to be possibly (n=143) or unlikely (n=217) medication-related. A parallel set of data from 360 patients who had not been readmitted was also included for comparison. The goal of the study was to identify risk factors associated with possible medication-related readmissions.

Patients who were readmitted due to medication-related reasons were significantly older (p=0.028), had more comorbidities (p<0.001), and were more dependent on municipality caregivers (p=0.023) than those in the no-readmission comparison group. They also tended to live alone (p=0.001).

Regression analysis revealed that comorbid patients (odds ratio [OR], 1.15, 95 percent confidence interval [CI], 1.05–1.25; p=0.002) who had excessive polypharmacy (OR, 1.74, 95 percent CI, 1.07–2.81; p=0.024) or who had had their dosages adjusted (OR, 1.63, 95 percent CI, 1.03–2.58; p=0.038) were significantly more likely to be readmitted for medication-related reasons.

Similarly, such a risk was significantly elevated among those who had had emergency admissions during the index hospitalization (OR, 5.13, 95 percent CI, 1.70–15.43; p=0.004) and had multiple admissions over the past year (OR, 1.33, 95 percent CI, 1.10–1.61; p=0.003).

Compared to living at home with a spouse or other people (OR, 0.59, 95 percent CI, 0.37–0.94; p=0.025) or to living in a nursing home (OR, 0.45, 95 percent CI, 0.21–0.95; p=0.037), living alone at home likewise significantly increased the likelihood of medication-related readmissions.