Evidence map›Paper›PMID 37536970›Full record

ArticleBMJ open2023

Identifying older adults at increased risk of medication-related readmission to hospital within 30 days of discharge: development and validation of a risk assessment tool.

Maria Glans, Thomas Gerardus Hendrik Kempen, Ulf Jakobsson, Annika Kragh Ekstam, Åsa Bondesson, Patrik Midlöv

Abstract read
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
  4. Article
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

6 authors.

Maria GlansCenter for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden maria.glans@med.lu.se.ORCID 0000-0003-1329-7977
Thomas Gerardus Hendrik KempenDepartment of Pharmacy, Uppsala University, Uppsala, Sweden.
Ulf JakobssonCenter for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden.
Annika Kragh EkstamKristianstad-Hässleholm Hospitals, Department of Orthopaedics, Region Skåne, Kristianstad, Sweden.
Åsa BondessonCenter for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden.
Patrik MidlövCenter for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden.ORCID 0000-0002-5871-8731

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveDeveloping and validating a risk assessment tool aiming to identify older adults (≥65 years) at increased risk of possibly medication-related readmission to hospital within 30 days of discharge.

designRetrospective cohort study.

settingThe risk score was developed using data from a hospital in southern Sweden and validated using data from four hospitals in the mid-eastern part of Sweden.

participantsThe development cohort (n=720) was admitted to hospital during 2017, whereas the validation cohort (n=892) was admitted during 2017-2018. MEASURES: The risk assessment tool aims to predict possibly medication-related readmission to hospital within 30 days of discharge. Variables known at first admission and individually associated with possibly medication-related readmission were used in development. The included variables were assigned points, and Youden's index was used to decide a threshold score. The risk score was calculated for all individuals in both cohorts. Area under the receiver operating characteristic (ROC) curve (c-index) was used to measure the discrimination of the developed risk score. Sensitivity, specificity and positive and negative predictive values were calculated using cross-tabulation.

resultsThe developed risk assessment tool, the Hospitalisations, Own home, Medications, and Emergency admission (HOME) Score, had a c-index of 0.69 in the development cohort and 0.65 in the validation cohort. It showed sensitivity 76%, specificity 54%, positive predictive value 29% and negative predictive value 90% at the threshold score in the development cohort.

conclusionThe HOME Score can be used to identify older adults at increased risk of possibly medication-related readmission within 30 days of discharge. The tool is easy to use and includes variables available in electronic health records at admission, thus making it possible to implement risk-reducing activities during the hospital stay as well as at discharge and in transitions of care. Further studies are needed to investigate the clinical usefulness of the HOME Score as well as the benefits of implemented activities.

Indexed as

Patient DischargePatient ReadmissionAgedHospitalsHumansRetrospective StudiesRisk AssessmentRisk Factorsgeriatric medicinehealth & safetyquality in health carerisk management

Identifiers

PMID37536970
PMCPMC10401249

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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.