Potentially preventable drug-related rehospitalizations in older adults: incidence and risk factors after interprofessional geriatric care
Annelie Friederike Goldbeck, Andrea Liekweg, Ingrid Becker, Rebekka Lenssen, Anna Maria Affeldt, Maria Cristina Polidori, Ulrich JaehdeAbstract
Background and Aims
Drug-related hospitalizations in older adults burden healthcare systems and reduce quality of life. Identifying risk factors may inform targeted strategies to reduce their frequency and impact.
Methods
We conducted a prospective observational study in a geriatric ward at the University Hospital of Cologne, Germany, where patients received interprofessional care including pharmacists. Of 226 patients aged ≥65 years recruited, 12 died during the index stay, leaving 214 for 90-day follow-up. The primary outcome was the occurrence of potentially preventable drug-related rehospitalizations within 90 days post-discharge. Patient-related characteristics, information about the hospital stay, and drug-related information were analyzed using both univariate and multivariate Cox regression models to identify risk factors for potentially preventable drug-related rehospitalizations.
Results
Median age was 80 years; 54% were male. Within 90 days post-discharge, 19 patients (9%) experienced a potentially preventable drug-related rehospitalization. Univariate analysis identified tacrolimus and sulfamethoxazole/trimethoprim as potential risk factors. In the multivariate Cox regression analysis, male sex, doxazosin, tacrolimus and bisoprolol were potential risk factors.
Conclusions
Although interprofessional care including pharmacists may reduce rehospitalization rates compared with standard care, the proportion of potentially preventable drug-related rehospitalizations within 90 days remains substantial. Certain drugs and male sex were identified as potential risk factors. Risk-informed interventions, layered onto interprofessional care, may reduce drug-related rehospitalizations in geriatric patients further.