Medication Use by Alternate Level of Care Patients: A Descriptive Analysis.

Mehrdad Azimi, Lisa Burry, Christinne Duclos, Jordan Pelc, Jason X Nie, Ross Upshur

Abstract read

In one paragraph

Article in The Canadian journal of hospital pharmacy. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

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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

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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

1 citing paper in PubMed.

Alternate Level of Care Patients in Canada: a Scoping Review.Canadian geriatrics journal : CGJ · 2024
Article

4 · The record

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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

6 authors.

Mehrdad Azimi, MSc, is a candidate in the PharmD program, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario. He is also with the Department of Pharmacy, Mount Sinai Hospital, Sinai Health System, Toronto, Ontario.

Lisa Burry, BScPharm, PharmD, FCCP, FCCM, is with the Leslie Dan Faculty of Pharmacy, University of Toronto, and the Department of Pharmacy and the Department of Medicine, Division of Intensive Care Medicine, Mount Sinai Hospital, Sinai Health System, Toronto, Ontario.

Christinne Duclos, BScPharm, PharmD, is with the Department of Pharmacy, Mount Sinai Hospital, Sinai Health System, Toronto, Ontario.

Jordan Pelc, MD, MSc, CCFP, is with the Department of Medicine, Bridgepoint Active Healthcare, the Division of General Internal Medicine, and the Interdepartmental Division of Hospital Medicine, Sinai Health System; and the Department of Family and Community Medicine, University of Toronto, Toronto, Ontario.

Jason X Nie, MSc, is with the Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario.

Ross Upshur, BA(Hons), MA, MD, MSc, CCFP, FRCPC, is with the Department of Medicine, Bridgepoint Active Healthcare, and the Lunenfeld-Tanenbaum Research Institute, Sinai Health System; and the Department of Family and Community Medicine and the Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe population of patients designated as alternate level of care (ALC) consists predominantly of frail older adults who are medically stable and awaiting discharge from hospital. They have complex medication regimens, often including potentially inappropriate medications (PIMs). There has been increasing emphasis on managing the burden that ALC patients place on the health care system, but little is known about their health care needs.

objectiveTo characterize the medication regimens, including use of PIMs, of ALC patients at the study institution.

methodsA cross-sectional chart audit of ALC patients was conducted between May and July 2017. For all patients in the sample, each medication was categorized by therapeutic class, and PIMs were categorized according to the Beers criteria, the STOPP/START criteria, and an established list of high-alert medications.

resultsA total of 82 patients met the audit criteria, for whom the mean number of chronic conditions was 6.4 (standard deviation [SD] 3.3) and the mean number of prescribed medications was 12.8 (SD 6.9). Twenty-four (29%) of the patients were receiving at least 1 drug from 7 different drug classes. All but one of the patients had PIMs in their regimen; the frequency of PIMs was highest according to the Beers criteria (mean 3.9 [SD 2.6] medications per patient).

conclusionsAt the study institution, ALC patients had on average more than 6 chronic conditions managed with at least 12 medications, of which one-quarter were PIMs. These data will be used to inform next steps in making recommendations to simplify, reduce, or discontinue medications for which there is an unclear indication, lack of effectiveness, or evidence of potential harm.

Indexed as

alternate level of careolder adultspolypharmacypotentially inappropriate medications

Identifiers

PMID31452539

PMCPMC6699862

What OpenQuestion holds

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Registered trials

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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.