A multi-centre cohort study on healthcare use due to medication-related harm: the role of frailty and polypharmacy.
Age Ageing
; 51(3)2022 03 01.
Article
em En
| MEDLINE
| ID: mdl-35353136
ABSTRACT
OBJECTIVES:
To determine the association between frailty and medication-related harm requiring healthcare utilisation.DESIGN:
Prospective observational cohort study.SETTING:
Six primary and five secondary care sites across South East England, September 2013-November 2015.PARTICIPANTS:
One thousand and two hundred and eighty participants, ≥65 years old, who were due for discharge from general medicine and older persons' wards following an acute episode of care. Exclusion criteria were limited life expectancy, transfer to another hospital and consent not gained. MAIN OUTCOMEMEASURES:
Medication-related harm requiring healthcare utilisation (including primary, secondary or tertiary care consultations related to MRH), including adverse drug reactions, non-adherence and medication error determined via the review of data from three sources patient/carer reports gathered through a structured telephone interview; primary care medical record review; and prospective consultant-led review of readmission to recruiting hospital. Frailty was measured using a Frailty Index, developed using a standardised approach. Marginal estimates were obtained from logistic regression models to examine how probabilities of healthcare service use due to medication-related harm were associated with increasing number of medicines and frailty.RESULTS:
Healthcare utilisation due to medication-related harm was significantly associated with frailty (OR = 10.06, 95% CI 2.06-49.26, P = 0.004), independent of age, gender, and number of medicines. With increasing frailty, the need for healthcare use as a result of MRH increases from a probability of around 0.2-0.4. This is also the case for the number of medicines.CONCLUSIONS:
Frailty is associated with MRH, independent of polypharmacy. Reducing the burden of frailty through an integrated health and social care approach, alongside strategies to reduce inappropriate polypharmacy, may reduce MRH related healthcare utilisation.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Polimedicação
/
Fragilidade
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
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Risk_factors_studies
Limite:
Aged
/
Aged80
/
Humans
Idioma:
En
Revista:
Age Ageing
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Reino Unido