Changes in medication regimen complexity and the risk for 90-day hospital readmission and/or emergency department visits in U.S. Veterans with heart failure

2016 ◽  
Vol 12 (5) ◽  
pp. 713-721 ◽  
Author(s):  
Felix K. Yam ◽  
Tiffany Lew ◽  
Satish A. Eraly ◽  
Hsiang-Wen Lin ◽  
Jan D. Hirsch ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Hospital Readmission ◽  
Emergency Department Visits ◽  
Day Hospital ◽  
Medication Regimen ◽  
Medication Regimen Complexity ◽  
Regimen Complexity

scholarly journals Medication regimen complexity in ambulatory older adults with heart failure

2017 ◽  
Vol Volume 12 ◽  
pp. 679-686 ◽  
Author(s):  
Michael Cobretti ◽  
Robert Page II ◽  
Sunny Linnebur ◽  
Kimberly Deininger ◽  
Amrut Ambardekar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Medication Regimen ◽  
Medication Regimen Complexity ◽  
Regimen Complexity

scholarly journals Medication-Related Factors and Hospital Readmission in Older Adults with Chronic Kidney Disease

2019 ◽  
Vol 8 (3) ◽  
pp. 395 ◽  
Author(s):  
Wubshet H. Tesfaye ◽  
Gregory M. Peterson ◽  
Ronald L. Castelino ◽  
Charlotte McKercher ◽  
Matthew Jose ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Hospital Readmission ◽  
Hospital Readmissions ◽  
Medication Regimen ◽  
Related Factors ◽  
Medication Regimen Complexity ◽  
Regimen Complexity ◽  
Medication Appropriateness

This study aimed to examine the association between medication-related factors and risk of hospital readmission in older patients with chronic kidney disease (CKD). A retrospective analysis was conducted targeting older CKD (n = 204) patients admitted to an Australian hospital. Medication appropriateness (Medication Appropriateness Index; MAI), medication regimen complexity (number of medications and Medication Regimen Complexity Index; MRCI) and use of selected medication classes were exposure variables. Outcomes were occurrence of readmission within 30 and 90 days, and time to readmission within 90 days. Logistic and Cox hazards regression were used to identify factors associated with readmission. Overall, 50 patients (24%) were readmitted within 30 days, while 81 (40%) were readmitted within 90 days. Mean time to readmission within 90 days was 66 (SD 34) days. Medication appropriateness and regimen complexity were not independently associated with 30- or 90-day hospital readmissions in older adults with CKD, whereas use of renin‒angiotensin blockers was associated with reduced occurrence of 30-day (adjusted OR 0.39; 95% CI 0.19–0.79) and 90-day readmissions (adjusted OR 0.45; 95% CI 0.24–0.84) and longer time to readmission within 90 days (adjusted HR 0.52; 95% CI 0.33–0.83). This finding highlights the importance of considering the potential benefits of individual medications during medication review in older CKD patients.

scholarly journals Medication regimen complexity and readmissions after hospitalization for heart failure, acute myocardial infarction, pneumonia, and chronic obstructive pulmonary disease

2016 ◽  
Vol 4 ◽  
pp. 205031211663242 ◽  
Author(s):  
Nada Abou-Karam ◽  
Chad Bradford ◽  
Kajua B Lor ◽  
Mitchell Barnett ◽  
Michelle Ha ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Acute Myocardial Infarction ◽  
Chronic Obstructive ◽  
Medication Regimen ◽  
Obstructive Pulmonary Disease ◽  
Medication Regimen Complexity ◽  
Complexity Index ◽  
Regimen Complexity

Objectives: Readmission rate is increasingly being viewed as a key indicator of health system performance. Medication regimen complexity index scores may be predictive of readmissions; however, few studies have examined this potential association. The primary objective of this study was to determine whether medication regimen complexity index is associated with all-cause 30-day readmission after admission for heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease. Methods: This study was an institutional review board–approved, multi-center, case–control study. Patients admitted with a primary diagnosis of heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease were randomly selected for inclusion. Patients were excluded if they discharged against medical advice or expired during their index visit. Block randomization was utilized for equal representation of index diagnosis and site. Discharge medication regimen complexity index scores were compared between subjects with readmission versus those without. Medication regimen complexity index score was then used as a predictor in logistic regression modeling for readmission. Results: Seven hundred and fifty-six patients were randomly selected for inclusion, and 101 (13.4%) readmitted within 30 days. The readmission group had higher medication regimen complexity index scores than the no-readmission group ( p < 0.01). However, after controlling for demographics, disease state, length of stay, site, and medication count, medication regimen complexity index was no longer a significant predictor of readmission (odds ratio 0.99, 95% confidence interval 0.97–1.01) or revisit (odds ratio 0.99, 95% confidence interval 0.98–1.02). Conclusion: There is little evidence to support the use of medication regimen complexity index in readmission prediction when other measures are available. Medication regimen complexity index may lack sufficient sensitivity to capture an effect of medication regimen complexity on all-cause readmission.

scholarly journals Thirty-day hospital readmission and emergency department visits after vascular surgery: a Canadian prospective cohort study

2018 ◽  
Vol 61 (4) ◽  
pp. 257-263 ◽  
Author(s):  
Muzammil H. Syed ◽  
Mohamad A. Hussain ◽  
Zeyad Khoshhal ◽  
Konrad Salata ◽  
Beidaa Altuwaijri ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Vascular Surgery ◽  
Prospective Cohort Study ◽  
Hospital Readmission ◽  
Prospective Cohort ◽  
Emergency Department Visits ◽  
Day Hospital
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