Two thirds of patients prescribed inappropriate medication at hospital discharge

Two in three older hospitalised patients were prescribed a potentially inappropriate medications (PIMs) at discharge leading to an increased risk of an adverse drug reaction.

The study published by the American Geriatrics Society examined information from medical and surgical patients to evaluate the association of PIMs (both the ones the patients had been taking earlier as well as those newly prescribed at their hospital discharge) with the risk of four outcomes. The outcomes were harmful drug problems, emergency department visits, readmission to the hospital, and death after hospital discharge.

It found that almost 10% of patients experienced a potentially harmful drug reaction and 36% visited the emergency department, were readmitted to the hospital, and/or died in the 30 days after their hospital discharge.

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The researchers concluded that older adults who have been hospitalised and who are prescribed PIMs experience an increase in potentially harmful drug reactions, emergency room visits, rehospitalisations, and death within 30 days of discharge.

Two-thirds of all patients had been prescribed at least one PIM at discharge

Information from 2,402 patients was included in the study. Overall, patients were around 76 years old, had been diagnosed with five health conditions, and had been prescribed approximately eight different medications at the time of their discharge.

The researchers learned that 1,576 people – nearly two-thirds of all patients – had been prescribed at least one PIM at discharge. This included both new PIMs and/or those continued from before their hospitalisation. Most patients were prescribed one PIM, and 1,176 patients were re-prescribed at least one of their previous PIMs. Nearly half of patients studied were prescribed with at least one new PIM.

This study was conducted in Quebec, Canada, where full information is available on all medical visits, emergency department visits, hospitalisations, and deaths. The researchers selected patients who were 65 years old or older and were discharged from one of the hospitals included in the study. When they were discharged, they were given prescriptions for one or more medications. Patients were followed until 30 days after their discharge or death, whichever came first.