Evidence map›Paper›PMID 28849426›Full record

ArticleJournal of general internal medicine2017

Hospitalization Risk and Potentially Inappropriate Medications among Medicare Home Health Nursing Patients.

Matthew C Lohman, Brandi P Cotton, Alexandra B Zagaria, Yuhua Bao, Rebecca L Greenberg, Karen L Fortuna, Martha L Bruce

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 3 pooled it
1.3field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 42 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Matthew C LohmanDepartment of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA. lohmanm@mailbox.sc.edu.
Brandi P CottonDepartment of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
Alexandra B ZagariaThe Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
Yuhua BaoDepartment of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
Rebecca L GreenbergInstitute of Geriatric Psychiatry, Weill Cornell Medical College, White Plains, NY, USA.
Karen L FortunaDepartment of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
Martha L BruceDepartment of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
Dartmouth College · USCornell University · USDartmouth Institute for Health Policy and Clinical Practice · US

Funding

Training Geriatric Mental Health Services ResearchersT32MH073553 · NIMH · DARTMOUTH-HITCHCOCK CLINIC · PI BRUCE, MARTHA L · 2005 to 2019
$6.4M
Homecare Agency-Randomized Trial of Web Implementation Strategy for DepressionR01MH096441 · NIMH · WEILL MEDICAL COLL OF CORNELL UNIV · PI BRUCE, MARTHA L · 2012 to 2015
$1.6M
NIMH NIH HHS R01 MH096441NIMH NIH HHS T32 MH073553
6 · The paper itself

Abstract

backgroundHospitalizations and potentially inappropriate medication (PIM) use are significant and costly issues among older home health patients, yet little is known about the prevalence of PIM use in home health or the relationship between PIM use and hospitalization risk in this population.

objectiveTo describe the prevalence of PIM use and association with hospitalization among Medicare home health patients.

designCross-sectional analysis using data from 132 home health agencies in the US. SUBJECTS: Medicare beneficiaries starting home health nursing services between 2013 and 2014 (n = 87,780). MAIN MEASURES: Prevalence of individual and aggregate PIM use at start of care, measured using the 2012 Beers criteria. Relative risk (RR) of 30-day hospitalization or re-hospitalization associated with individual and aggregate PIM use, compared to no PIM use. KEY

resultsIn total, 30,168 (34.4%) patients were using at least one PIM, with 5969 (6.8%) taking at least two PIMs according to the Beers list. The most common types of PIMs were those affecting the brain or spinal cord, analgesics, and medications with anticholinergic properties. With the exception of nonsteroidal anti-inflammatory drugs (NSAIDs), PIM use across all classes was associated with elevated risk (10-33%) of hospitalization compared to non-use. Adjusting for demographic and clinical characteristics, patients using at least one PIM (excluding NSAIDs) had a 13% greater risk (RR = 1.13, 95% CI: 1.09, 1.17) of being hospitalized than patients using no PIMs, while patients using at least two PIMs had 21% greater risk (RR = 1.21, 95% CI: 1.12, 1.30). Similar associations were found between PIMs and re-hospitalization risk among patients referred to home health from a hospital.

conclusionsGiven the high prevalence of PIM use and the association between PIMs and hospitalization risk, home health episodes represent opportunities to substantially reduce PIM use among older adults and prevent adverse outcomes. Efforts to address medication use during home health episodes, hospitalizations, and care transitions are justified.

Indexed as

AgedAged, 80 and overComorbidityCross-Sectional StudiesFemaleHome Health NursingHospitalizationHumansInappropriate PrescribingMaleMedicarePotentially Inappropriate Medication ListRisk AssessmentUnited Stateshome careMedicarepharmacoepidemiology

Identifiers

PMID28849426
PMCPMC5698223
OpenAlexW2750157934

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.