ArticleBMJ quality & safety2020
Medication-related harm in older adults following hospital discharge: development and validation of a prediction tool.
Article in BMJ quality & safety, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- Preventable medication harm across health care settings: a systematic review and meta-analysis.BMC medicine · 2020Pooled it
- Prevalence and Nature of Medication Errors and Medication-Related Harm Following Discharge from Hospital to Community Settings: A Systematic Review.Drug safety · 2020Pooled it
- Implementation of a medicine management plan (MMP) to reduce medication-related harm (MRH) in older people post-hospital discharge: a randomised controlled trial.BMC geriatrics · 2022Trial
- General practice follow-up after hospital discharge in older adults: retrospective record analysis in UK primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- An Evaluation of Clinician and Informatician Perspectives on Medication Harm Risk Prediction Tools for Use in a Tertiary Hospital Setting.Journal of evaluation in clinical practice · 2026Article
- Pilot of a novel patient-led intervention for postdischarge from hospital management of older patients' care in general practice.Family medicine and community health · 2026Article
- Implementation of a pharmacist‑led discharge intervention to improve medication information handover at hospital discharge: a non-randomised feasibility study.BMC health services research · 2026Article
- Disposition at Equipoise: A Qualitative Study of Emergency Physicians' Decision-Making About Hospitalizing People With Dementia.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Cognitive Interviews With Emergency Physicians to Understand Disposition Decisions With People With Dementia With Borderline Cases.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
- Managing emergency department patients with potential medication-related harm: a qualitative study.International journal of clinical pharmacy · 2026Article
- Criteria pharmacists use to refer patients to a post discharge pharmacist review clinic.Exploratory research in clinical and social pharmacy · 2025Article
- Co-design of a multifaceted intervention to improve quality handover of medicine information at discharge from hospital.BMC health services research · 2025Article
- Article
- Adverse drug reactions and events in an Ageing PopulaTion risk Prediction (ADAPTiP) tool: the development and validation of a model for predicting adverse drug reactions and events in older patients.European geriatric medicine · 2025Article
- Assessing patient work system factors for medication management during transition of care among older adults: an observational study.BMJ quality & safety · 2024Observational
- Development and validation of risk prediction model for adverse outcomes in trauma patients.Annals of medicine · 2024Article
- High-risk medication use among older adults with cognitive impairment living alone in the United States.Journal of the American Geriatrics Society · 2024Article
- Prevalence of Adverse Drug Reactions in Hospital Among Older Patients with and Without Dementia.Drugs & aging · 2024Article
- Introducing a pharmacist-led transmural care program to reduce drug-related problems in orthogeriatric patients: a prospective interventional study.BMC geriatrics · 2024Article
- Article
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 2 countries.
Funding
Abstract
objectivesTo develop and validate a tool to predict the risk of an older adult experiencing medication-related harm (MRH) requiring healthcare use following hospital discharge. DESIGN, SETTING,
participantsMulticentre, prospective cohort study recruiting older adults (≥65 years) discharged from five UK teaching hospitals between 2013 and 2015. PRIMARY OUTCOME MEASURE: Participants were followed up for 8 weeks in the community by senior pharmacists to identify MRH (adverse drug reactions, harm from non-adherence, harm from medication error). Three data sources provided MRH and healthcare use information: hospital readmissions, primary care use, participant telephone interview. Candidate variables for prognostic modelling were selected using two systematic reviews, the views of patients with MRH and an expert panel of clinicians. Multivariable logistic regression with backward elimination, based on the Akaike Information Criterion, was used to develop the PRIME tool. The tool was internally validated.
results1116 out of 1280 recruited participants completed follow-up (87%). Uncertain MRH cases ('possible' and 'probable') were excluded, leaving a tool derivation cohort of 818. 119 (15%) participants experienced 'definite' MRH requiring healthcare use and 699 participants did not. Modelling resulted in a prediction tool with eight variables measured at hospital discharge: age, gender, antiplatelet drug, sodium level, antidiabetic drug, past adverse drug reaction, number of medicines, living alone. The tool's discrimination C-statistic was 0.69 (0.66 after validation) and showed good calibration. Decision curve analysis demonstrated the potential value of the tool to guide clinical decision making compared with alternative approaches.
conclusionsThe PRIME tool could be used to identify older patients at high risk of MRH requiring healthcare use following hospital discharge. Prior to clinical use we recommend the tool's evaluation in other settings.
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Registered trials
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.