What happens to the medication regimens of older adults during and after an acute hospitalization?

Ché Matthew Harris, Anirudh Sridharan, Regina Landis, Eric Howell, Scott Wright

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Hospitalized elderly patients are at risk for medication errors and nonadherence when discharged home. OBJECTIVE: To describe how older patients' medications change during and after hospitalizations and what patients ultimately take after discharge. Methods: We conducted an observational cohort study of 95 patients aged 65 years and older admitted to Johns Hopkins Bayview Medical Center in 2007. Inclusion criteria included admissions longer than 24 hours and discharge to home. Medication lists from three periods were recorded: prehospitalization, day of discharge, and 3 days after discharge. In comparing lists, we characterized: new and discontinued medications, changes in dosage, and changes in frequency. Results: Before admission, patients were taking a total of 701 medications (mean, 7 per patient). Upon discharge, 192 new medicines were started (2.0 per patient), 76 discontinued (0.8 per patient), 67 changed in frequency, (0.7 per patient), and 45 changed in dosage (0.5 per patient). Antibiotics and antihypertensives were the most commonly prescribed new medications. Antihypertensives were also most likely to be discontinued. At day 3 after discharge, patients were adherent with 98% (763/778) of medications. However, 25% of antihypertensives and 88% analgesics discontinued by hospitalists on the day of discharge were reinitiated by patients upon their return home. Conclusions: During hospitalizations, medications of older adults change substantially. Despite clear medication reconciliation efforts in the hospital environment, medication errors occur upon discharge to home. Because current standards are yielding suboptimal results, alternate methodologies for promoting medication adherence should also be considered, developed, and studied for effectiveness.

Original languageEnglish (US)
Pages (from-to)150-153
Number of pages4
JournalJournal of patient safety
Volume9
Issue number3
DOIs
StatePublished - Sep 1 2013

Keywords

  • elderly
  • medication adherence
  • patient safety
  • polypharmacy
  • transitions of care

ASJC Scopus subject areas

  • Leadership and Management
  • Public Health, Environmental and Occupational Health

Fingerprint Dive into the research topics of 'What happens to the medication regimens of older adults during and after an acute hospitalization?'. Together they form a unique fingerprint.

Cite this