BACKGROUND: Chronic kidney disease (CKD) is characterized by high rates of hospital admissions and readmissions. However, there is a scarcity of research into medication-related factors predicting such outcomes in this patient group. OBJECTIVE: To evaluate the effect of medication regimen complexity at hospital discharge on subsequent readmissions and their timing in older adults with CKD. METHODS: This was a 12-month retrospective cohort study of 204 older (⩾65 years) CKD patients in an Australian tertiary care hospital. Medication regimen complexity was quantified using the 65-item medication regimen complexity index (MRCI). The outcomes were the occurrence of readmission in 30 days and time to readmission within 12 months. Logistic regression was used to identify factors predicting 30-day readmission, and a competing risks proportional subdistribution hazard model, accounting for deaths, was used for factors predicting time to readmission. RESULTS: Overall, 50 (24%) patients, predominantly men (72%), were readmitted within 30 days of follow-up. MRCI was not significantly associated with 30-day readmission (odds ratio [OR] = 1.27; 95% CI = 0.94-1.73). The median (interquartile range) time to readmission within 12 months was 145 (31-365) days. On a multivariate analysis, a 10-unit increase in MRCI was associated with a shorter time to readmission within 12 months (subdistribution HR = 1.18; 95% CI = 1.01-1.36). Conclusion and Relevance: Medication regimen complexity was not significantly associated with 30-day readmission; however, it was associated with a significantly shorter time to 12-month readmission in older CKD patients. This finding highlights the importance of medication regimen complexity as a potential target for medical interventions to reduce readmission risks.
BACKGROUND:Chronic kidney disease (CKD) is characterized by high rates of hospital admissions and readmissions. However, there is a scarcity of research into medication-related factors predicting such outcomes in this patient group. OBJECTIVE: To evaluate the effect of medication regimen complexity at hospital discharge on subsequent readmissions and their timing in older adults with CKD. METHODS: This was a 12-month retrospective cohort study of 204 older (⩾65 years) CKDpatients in an Australian tertiary care hospital. Medication regimen complexity was quantified using the 65-item medication regimen complexity index (MRCI). The outcomes were the occurrence of readmission in 30 days and time to readmission within 12 months. Logistic regression was used to identify factors predicting 30-day readmission, and a competing risks proportional subdistribution hazard model, accounting for deaths, was used for factors predicting time to readmission. RESULTS: Overall, 50 (24%) patients, predominantly men (72%), were readmitted within 30 days of follow-up. MRCI was not significantly associated with 30-day readmission (odds ratio [OR] = 1.27; 95% CI = 0.94-1.73). The median (interquartile range) time to readmission within 12 months was 145 (31-365) days. On a multivariate analysis, a 10-unit increase in MRCI was associated with a shorter time to readmission within 12 months (subdistribution HR = 1.18; 95% CI = 1.01-1.36). Conclusion and Relevance: Medication regimen complexity was not significantly associated with 30-day readmission; however, it was associated with a significantly shorter time to 12-month readmission in older CKDpatients. This finding highlights the importance of medication regimen complexity as a potential target for medical interventions to reduce readmission risks.
Authors: Janet K Sluggett; Ria E Hopkins; Esa Yh Chen; Jenni Ilomäki; Megan Corlis; Jan Van Emden; Michelle Hogan; Tessa Caporale; Choon Ean Ooi; Sarah N Hilmer; J Simon Bell Journal: J Clin Med Date: 2020-04-08 Impact factor: 4.241
Authors: Ajay S Padaki; Venkat Boddapati; Justin Mathew; Christopher S Ahmad; Charles M Jobin; William N Levine Journal: JSES Open Access Date: 2019-09-16
Authors: A E M J H Linkens; V Milosevic; P H M van der Kuy; V H Damen-Hendriks; C Mestres Gonzalvo; K P G M Hurkens Journal: Int J Clin Pharm Date: 2020-05-30
Authors: Mohammad A Al-Mamun; Jacob Strock; Yushuf Sharker; Khaled Shawwa; Rebecca Schmidt; Douglas Slain; Ankit Sakhuja; Todd N Brothers Journal: J Clin Med Date: 2022-08-11 Impact factor: 4.964
Authors: Carole E Aubert; Niklaus Fankhauser; Pedro Marques-Vidal; Jérôme Stirnemann; Drahomir Aujesky; Andreas Limacher; Jacques Donzé Journal: BMC Health Serv Res Date: 2019-10-17 Impact factor: 2.655