Can doctors identify older patients at risk of medication harm following hospital discharge?

July 2, 2018, Wiley
Credit: CC0 Public Domain

Medication-related harm (MRH) is common in older adults following hospital discharge. A new British Journal of Clinical Pharmacology study has examined whether doctors can predict which older patients will experience MRH requiring care following hospital discharge, and whether clinical experience and confidence in prediction influence the accuracy of predictions.

The study found that clinical judgement of doctors is not a reliable tool to predict MRH in post-discharge.

In the multicentre observational prospective study involving five teaching hospitals in England between September 2013 and November 2015, there were 1066 patients with completed predictions and follow-up. Doctors discharging from medical wards predicted the likelihood of their patient experiencing MRH requiring care in the initial 8 week period post-discharge.

Most predictions (85 percent) were made by junior doctors with less than 5 years' clinical experience. There was no relationship between ' predictions and patient MRH, irrespective of years of . Doctors' predictions were more likely to be accurate when they reported higher confidence in their prediction, especially in predicting MRH-associated hospital readmissions.

"These findings confirm the complexity of predicting medication-related harm.This makes it very challenging to target medication-related strategies to the right individuals," said Dr. Khalid Ali, chief investigator of the study and senior lecturer in Geriatrics at Brighton and Sussex Medical School. "Clinical pharmacology and therapeutics teaching has not been particularly prominent in undergraduate medical training. This is perhaps an area requiring review, given an ageing population that is prescribed ever increasing quantities of medicine." Dr. Ali added that there is a need to consider new approaches to identify individuals at high risk of medication-related harm given its serious impact on patients and health care services.

Explore further: Medication-related harm in older adults is common, costly, and preventable

More information: Nikesh Parekh et al. Can doctors identify older patients at risk of medication harm following hospital discharge? A multicentre prospective study in the UK, British Journal of Clinical Pharmacology (2018). DOI: 10.1111/bcp.13690

Related Stories

Medication-related harm in older adults is common, costly, and preventable

May 23, 2018
New research indicates that harm from medicines is common in older adults following hospital discharge, and it results in substantial use of healthcare resources. In the British Journal of Clinical Pharmacology study, medication-related ...

Rx discrepancies common in hospital discharge summaries

December 19, 2017
(HealthDay)—For older patients discharged from a regional hospital, there are frequently discrepancies between the electronic discharge summaries and the National Inpatient Medication Chart (NIMC) or discharge prescription, ...

Dementia increases the risk of 30-day readmission to the hospital after discharge

February 23, 2018
About 25 percent of older adults admitted to hospitals have dementia and are at increased risk for serious problems like in-hospital falls and delirium (the medical term for an abrupt, rapid change in mental function). As ...

Many older adults discharged from the hospital receive inappropriate prescriptions

May 11, 2018
In a British Journal of Clinical Pharmacology study of 259 older adults discharged from a general medical hospital, more than 4 in 5 patients were issued a potentially inappropriate prescription containing at least 1 potentially ...

Impact of complex medication regimen in elderly unclear

December 23, 2016
(HealthDay)—The association between medication regimen complexity and either treatment nonadherence or hospitalization in elderly patients remains unclear, according to a review published online Dec. 19 in the Journal of ...

Researchers use health data to predict who will use opioids after hospitalization

March 5, 2018
Researchers at the University of Colorado Anschutz Medical Campus are working to develop statistical models to better predict which patients will be prescribed opioid medications long-term following discharge from a hospital ...

Recommended for you

Lowering hospitals' Medicare costs proves difficult

July 18, 2018
A payment system that provides financial incentives for hospitals that reduce health-care costs for Medicare patients did not lower costs as intended, according to a new study led by Washington University School of Medicine ...

Eating iron-fortified grain improves students' attention, memory

July 18, 2018
Adolescent students in a rural school in India who consumed an iron-biofortified version of the grain pearl millet exhibited improved attention and memory compared to those who consumed conventional pearl millet, according ...

Vaping tied to blood clots—in mice

July 18, 2018
A new study involving mice raises another concern about the danger of e-cigarettes in humans after experiments showed that short-term exposure to the device's vapors appeared to increase the risk of clot formation.

Sugar improves memory in over-60s, helping them work smarter

July 18, 2018
Sugar improves memory in older adults – and makes them more motivated to perform difficult tasks at full capacity – according to new research by the University of Warwick.

People who tan in gyms tan more often, and more addictively, than others, new research shows

July 18, 2018
Gyms are places people go to get healthier. But nearly half the gyms in the U.S. contain a potentially addictive carcinogen—tanning beds, report UConn researchers in the July 18 issue of JAMA Dermatology.

Study shows that people most affected by alcohol also most impacted by sleep deprivation

July 17, 2018
A team of researchers from the German Aerospace Center and Forschungszentrum Jülich has found that people who are most susceptible to alcohol intoxication are also most susceptible to cognitive problems due to sleep deprivation. ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.