ArticleAge and ageing2025
Impact of in-hospital medication changes on clinical outcomes in older inpatients: the journey and destination.
Article in Age and ageing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Drug or Pokémon? An analysis of the ability of large language models to discern fabricated medications.medRxiv : the preprint server for health sciences · 2026Article
- Drug-drug interaction identification using large language models.medRxiv : the preprint server for health sciences · 2025Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMedication review is integral in the pharmacological management of older inpatients.
objectiveTo assess the association of in-hospital medication changes with 28-day postdischarge clinical outcomes.
methodsRetrospective cohort of 2000 inpatients aged ≥75 years. Medication changes included the number of increases (medications started or dose-increased) and decreases (medications stopped or dose-decreased) for (i) all medications, (ii) Drug Burden Index (DBI)-contributing medications and (iii) Beers Criteria 2015 medications (potentially inappropriate medications, PIMs). Changes also included differences in (i) the number of medications, (ii) the number of PIMs and (iii) DBI score, at discharge versus admission. Associations with clinical outcomes (28-day ED visit, readmission and mortality) were ascertained using logistic regression, adjusted for age, gender and principal diagnosis. For mortality, sensitivity analysis excluded end-of-life patients due to higher death risk. Patients were stratified into : (i) ≤4, (ii) 5-9 and (iii) ≥10 discharge medications.
resultsThe mean age was 86 years (SD = 5.8), with 59.1% female. Medication changes reduced ED visits and readmission risk for patients prescribed five to nine discharge medications, with no associations in patients prescribed ≤4 and ≥ 10 medications. In the five to nine medications group, decreasing PIMs reduced risks of ED visit (adjusted odds ratio, aOR 0.55, 95% CI 0.34-0.91, P = .02) and readmission (aOR 0.62, 95% CI 0.38-0.99, P = .04). Decreasing DBI-contributing medications reduced readmission risk (aOR 0.71, 95% CI 0.51-0.99, P = .04). Differences in PIMs reduced ED visit risk (aOR 0.65, 95% CI 0.43-0.99, P = .04). There were no associations with mortality in sensitivity analyses in all groups. DISCUSSION: Medication changes were associated with reduced ED visits and readmission for patients prescribed five to nine discharge medications.
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