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Hospital Admissions due to Medication-Related Harm in the Last 5 Years of Life: A Cohort Study.

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Názov: Hospital Admissions due to Medication-Related Harm in the Last 5 Years of Life: A Cohort Study.
Autori: Mullan JR; Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia., Moules S; Australasian Health Outcomes Centre, University of Wollongong, Wollongong, New South Wales, Australia., Bonney A; Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.
Zdroj: Australasian journal on ageing [Australas J Ageing] 2025 Dec; Vol. 44 (4), pp. e70104.
Spôsob vydávania: Journal Article
Jazyk: English
Informácie o časopise: Publisher: published on behalf of ACOTA by Wiley-Blackwell Publishing Asia Country of Publication: Australia NLM ID: 9808874 Publication Model: Print Cited Medium: Internet ISSN: 1741-6612 (Electronic) Linking ISSN: 14406381 NLM ISO Abbreviation: Australas J Ageing Subsets: MEDLINE
Imprint Name(s): Publication: Melbourne : published on behalf of ACOTA by Wiley-Blackwell Publishing Asia
Original Publication: Melbourne, Vic. : Council on the Ageing (Australia), [1998-
Výrazy zo slovníka MeSH: Drug-Related Side Effects and Adverse Reactions*/epidemiology , Drug-Related Side Effects and Adverse Reactions*/diagnosis , Drug-Related Side Effects and Adverse Reactions*/therapy , Drug-Related Side Effects and Adverse Reactions*/mortality , Patient Admission* , Hospitalization*, Humans ; Aged ; Female ; Male ; Retrospective Studies ; Aged, 80 and over ; Risk Factors ; Age Factors ; Australia/epidemiology ; Time Factors ; Comorbidity ; Risk Assessment
Abstrakt: Introduction: The World Health Organization (WHO) launched the third Global Patient Safety Challenge: Medication without Harm in 2017, aiming to reduce avoidable medication-related harm. Recognising that medication-related harm (MRH) accounts for the highest proportion of preventable harm, this initiative remains active and evolving. This study investigates the demographic and clinical factors associated with medication-related hospital admissions among a cohort of decedents.
Methods: A retrospective cohort study was conducted using routinely collected non-identifiable linked data from an Australian Local Health District (LHD). The study population comprised residents aged 65 years and over who died in one of the LHD hospitals between 2017 and 2019. Logistic regression models were used to estimate unadjusted and fully adjusted odds ratios for medication-related hospital admissions.
Results: Among the 4353 decedents, 31%-40% experienced at least one hospital admission due to MRH in the last 5 years of life, accounting for 5% of total admissions. Higher rates of medication-related admissions were observed among individuals aged below 70 years, those residing in metropolitan areas and residential aged care facility residents. Comorbidities such as renal failure, heart failure, transient ischaemic attack, hypertension, diabetes and chronic obstructive pulmonary disease (COPD) were significant predictors of medication-related admissions.
Conclusions: In our cohort of decedents, one-third had at least one hospitalisation due to MRH in their final 5 years. Higher risk was associated with being under 70 years of age, living in metropolitan or aged care settings and having multiple or specific chronic conditions. These results highlight the need for targeted interventions for high-risk individuals nearing the end of life.
(© 2025 AJA Inc.)
References: WHO, “Third WHO Global Patient Safety Challenge: Medication Without Harm,” (2017), https://www.who.int/initiatives/medication‐without‐harm.
WHO, “Medication Safety. WHO Global Patient Safety Challenge: Medication Without Harm,” (2022), accessed November 01, 2022, https://www.who.int/campaigns/world‐patient‐safety‐day/2022.
WHO, Global Patient Safety Report (World Health Organization, 2024).
A. Hodkinson, N. Tyler, D. M. Ashcroft, et al., “Preventable Medication Harm Across Health Care Settings: A Systematic Review and Meta‐Analysis,” BMC Medicine 18, no. 1 (2020): 313.
E. E. Roughead, S. J. Semple, and E. Rosenfeld, “The Extent of Medication Errors and Adverse Drug Reactions Throughout the Patient Journey in Acute Care in Australia,” International Journal of Evidence‐Based Healthcare 14 (2016): 113–122.
E. Roughead, “The Nature and Extent of Drug‐Related Hospitalisations in Australia,” Journal of Quality in Clinical Practice 19, no. 1 (1999): 19–22.
R. Lim, L. M. K. Ellett, S. Semple, and E. E. Roughead, “The Extent of Medication‐Related Hospital Admissions in Australia: A Review From 1988 to 2021,” Drug Safety 45, no. 3 (2022): 249–257.
J. Komagamine and M. Kobayashi, “Prevalence of Hospitalisation Caused by Adverse Drug Reactions at an Internal Medicine Ward of a Single Centre in Japan: A Cross‐Sectional Study,” BMJ Open 9, no. 8 (2019): e030515.
L. T. Silva, A. C. F. Modesto, R. G. Amaral, and F. M. Lopes, “Hospitalizations and Deaths Related to Adverse Drug Events Worldwide: Systematic Review of Studies With National Coverage,” European Journal of Clinical Pharmacology 78, no. 3 (2022): 435–466.
J. Sultana, P. Cutroneo, and G. Trifirò, “Clinical and Economic Burden of Adverse Drug Reactions,” Journal of Pharmacology and Pharmacotherapeutics 4, no. Suppl 1 (2013): S73–S77.
M. F. Rasool, A. U. Rehman, I. Imran, et al., “Risk Factors Associated With Medication Errors Among Patients Suffering From Chronic Disorders,” Frontiers in Public Health 8 (2020): 531038.
A. Al Hamid, M. Ghaleb, H. Aljadhey, and Z. Aslanpour, “A Systematic Review of Hospitalization Resulting From Medicine‐Related Problems in Adult Patients,” British Journal of Clinical Pharmacology 78, no. 2 (2014): 202–217.
WHO, Medication Safety in Polypharmacy (World Health Organization, 2019).
Pharmaceutical Society of Australia, Medication Safety: Rural and Remote Care (Pharmaceutical Society of Australia, 2021).
C. A. Cadogan, M. Murphy, M. Boland, K. Bennett, S. McLean, and C. Hughes, “Prescribing Practices, Patterns, and Potential Harms in Patients Receiving Palliative Care: A Systematic Scoping Review,” Exploratory Research in Clinical and Social Pharmacy 3 (2021): 100050.
D. Rowett and D. Currow, “Pharmacovigilance in Palliative Care,” Australian Prescriber 37, no. 6 (2014): 204–208.
M. J. McNeil, A. H. Kamal, J. S. Kutner, C. S. Ritchie, and A. P. Abernethy, “The Burden of Polypharmacy in Patients Near the End of Life,” Journal of Pain and Symptom Management 51, no. 2 (2016): 178–183.e2.
S. Masumoto, T. Hosoi, T. Nakamura, and J. Hamano, “Polypharmacy and Potentially Inappropriate Medications in Patients With Advanced cancer: Prevalence and Associated Factors at the End of Life,” Journal of Palliative Medicine 27, no. 6 (2024): 749–755.
S. W. Pit, J. E. Byles, and J. Cockburn, “Prevalence of Self‐Reported Risk Factors for Medication Misadventure Among Older People in General Practice,” Journal of Evaluation in Clinical Practice 14, no. 2 (2008): 203–208.
S. B. Srivastava, “Polypharmacy, Unintended Consequences, and Impact of Lifestyle Medicine,” American Journal of Lifestyle Medicine 18, no. 1 (2024): 54–57.
L. Ye, J. Yang‐Huang, C. B. Franse, et al., “Factors Associated With Polypharmacy and the High Risk of Medication‐Related Problems Among Older Community‐Dwelling Adults in European Countries: A Longitudinal Study,” BMC Geriatrics 22 (2022): 841.
Government, N, “Illawarra Shoalhaven Local Health District,” (2024), https://www.islhd.health.nsw.gov.au/.
Centre for Health Research Illawarra Shoalhaven Population, CHRISP Data Policy (University of Wollongong, 2016).
V. Sundararajan, T. Henderson, C. Perry, A. Muggivan, H. Quan, and W. A. Ghali, “New ICD‐10 Version of the Charlson Comorbidity Index Predicted In‐Hospital Mortality,” Journal of Clinical Epidemiology 57 (2004): 1288–1294.
Australian Commission on Safety and Quality in Health Care, “Classification of Hospital Acquired Diagnosis,” (2017), accessed September 9, 2025, https://www.safetyandquality.gov.au/sites/default/files/migrated/Classification‐of‐Hospital‐Acquired‐Diagnoses‐CHADx‐ICD‐10.xlsx.
ABS, Socio‐Economic Indexes for Areas (SEIFA), Australia, 2016 (Census of Population and Housing, 2018), https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/2033.0.55.001~2016~Main%20Features~IRSD~19.
ABS, Australian Statistical Geography Standard (ASGS) Edition 3 (ABS, 2023), https://www.abs.gov.au/statistics/standards/australian‐statistical‐geography‐standard‐asgs‐edition‐3/jul2021‐jun2026/remoteness‐structure/remoteness‐areas.
R Development Core Team, “An Introduction to R,” (2008).
D. Curtin, D. O'Mahony, and P. Gallagher, “Drug Consumption and Futile Medication Prescribing in the Last Year of Life: An Observational Study,” Age and Ageing 47, no. 5 (2018): 749–753.
L. Morin, D. L. Vetrano, D. Rizzuto, A. Calderón‐Larrañaga, J. Fastbom, and K. Johnell, “Choosing Wisely? Measuring the Burden of Medications in Older Adults Near the End of Life: Nationwide, Longitudinal Cohort Study,” American Journal of Medicine 130, no. 8 (2017): 927–936.e9.
M. H. Beers, “Age‐Related Changes as a Risk Factor for Medication‐Related Problems,” Generations 24, no. 4 (2000): 22–27.
J. M. Stevenson, N. Parekh, K. C. Chua, et al., “A Multi‐Centre Cohort Study on Healthcare Use due to Medication‐Related Harm: The Role of Frailty and Polypharmacy,” Age and Ageing 51, no. 3 (2022): afac054.
F. C. Martin and J. M. Stevenson, “Challenges of Medication‐Related Harm in Older Adults: Not Always in Plain Sight,” Polish Archives of Internal Medicine 131, no. 1 (2021): 3–4.
S. F. Chang, H. C. Lin, and C. L. Cheng, “The Relationship of Frailty and Hospitalization Among Older People: Evidence From a Meta‐Analysis,” Journal of Nursing Scholarship 50, no. 4 (2018): 383–391.
L. Alston, J. Jacobs, S. Allender, and M. Nichols, “A Comparison of the Modelled Impacts on CVD Mortality if Attainment of Public Health Recommendations Was Achieved in Metropolitan and Rural Australia,” Public Health Nutrition 23, no. 2 (2020): 339–347.
A. Phillips, “Health Status Differentials Across Rural and Remote Australia,” Australian Journal of Rural Health 17 (2009): 2–9.
J. K. Sluggett, J. Ilomäki, K. L. Seaman, M. Corlis, and J. S. Bell, “Medication Management Policy, Practice and Research in Australian Residential Aged Care: Current and Future Directions,” Pharmacological Research 116 (2017): 20–28.
J. B. Hillen, A. Vitry, and G. E. Caughey, “Medication‐Related Quality of Care in Residential Aged Care: An Australian Experience,” International Journal for Quality in Health Care 31, no. 4 (2019): 298–306.
L. M. Kalisch Ellett, G. M. Kassie, G. E. Caughey, N. L. Pratt, E. N. Ramsay, and E. E. Roughead, “Medication‐Related Hospital Admissions in Aged Care Residents,” Australasian Journal on Ageing 40, no. 4 (2021): e323–e331.
S. Ali, C. M. Curtain, G. M. Peterson, and M. S. Salahudeen, “Exploring Australian Pharmacists' Perceptions and Practices Towards Reducing the Risk of Medicines‐Related Harm in Aged Care Residents,” Frontiers in Pharmacology 14 (2023): 1131456.
H. Almutairi, A. Stafford, C. Etherton‐Beer, and L. Flicker, “Optimisation of Medications Used in Residential Aged Care Facilities: A Systematic Review and Meta‐Analysis of Randomised Controlled Trials,” BMC Geriatrics 20, no. 1 (2020): 236.
R. G. Buhr, N. J. Jackson, G. F. Kominski, S. M. Dubinett, M. K. Ong, and C. M. Mangione, “Comorbidity and Thirty‐Day Hospital Readmission Odds in Chronic Obstructive Pulmonary Disease: A Comparison of the Charlson and Elixhauser Comorbidity Indices,” BMC Health Services Research 19, no. 1 (2019): 701.
F.‐J. Ruiz‐Laiglesia, M. Sanchez‐Marteles, J. I. Perez‐Calvo, et al., “Comorbidity in Heart Failure. Results of the Spanish RICA Registry,” QJM: An International Journal of Medicine 107, no. 12 (2014): 989–994.
A. Al Hamid, Z. Aslanpour, H. Aljadhey, and M. Ghaleb, “Hospitalisation Resulting From Medicine‐Related Problems in Adult Patients With Cardiovascular Diseases and Diabetes in the United Kingdom and Saudi Arabia,” International Journal of Environmental Research and Public Health 13, no. 5 (2016): 479.
A. Vonna, M. S. Salahudeen, and G. M. Peterson, “Medication‐Related Hospital Admissions and Emergency Department Visits in Older People With Diabetes: A Systematic Review,” Journal of Clinical Medicine 13, no. 2 (2024): 530.
Z. Očovská, J. Procházková, M. Maříková, and J. Vlček, “Renal Drug Dosage Adjustments and Adverse Drug Events in Patients With Chronic Kidney Disease Admitted to the Hospital: A Cross‐Sectional Study,” Expert Opinion on Drug Safety 23, no. 4 (2024): 457–467.
M. Carollo, S. Crisafulli, G. Vitturi, et al., “Clinical Impact of Medication Review and Deprescribing in Older Inpatients: A Systematic Review and meta‐Analysis,” Journal of the American Geriatrics Society 72, no. 10 (2024): 3219–3238.
N. Jokanovic, E. C. K. Tan, D. van den Bosch, C. M. Kirkpatrick, M. J. Dooley, and J. S. Bell, “Clinical Medication Review in Australia: A Systematic Review,” Research in Social and Administrative Pharmacy 12, no. 3 (2016): 384–418.
J. Walston, B. Buta, and Q. L. Xue, “Frailty Screening and Interventions: Considerations for Clinical Practice,” Clinics in Geriatric Medicine 34, no. 1 (2018): 25–38.
D. Curtin, E. Jennings, R. Daunt, et al., “Deprescribing in Older People Approaching End of Life: A Randomized Controlled Trial Using STOPPFrail Criteria,” Journal of the American Geriatrics Society 68, no. 4 (2020): 762–769.
W. Lin, S. Haq, S. Sinha, and C. Fan‐Lun, “Impact Analysis of a Pharmacist‐Led Home‐Medication Review Service Within an Interprofessional Outreach Team,” Senior Care Pharmacist 36, no. 3 (2021): 159–170.
J. M. Stevenson, J. G. Davies, and F. C. Martin, “Medication‐Related Harm: A Geriatric Syndrome,” Age and Ageing 49, no. 1 (2019): 7–11.
A. J. Wheeler, S. Scahill, D. Hopcroft, and H. Stapleton, “Reducing Medication Errors at Transitions of Care Is Everyone's Business,” Australian Prescriber 41, no. 3 (2018): 73–77.
Contributed Indexing: Keywords: aged; comorbidity; frailty; hospitalisation; medication errors; polypharmacy
Entry Date(s): Date Created: 20251023 Date Completed: 20251023 Latest Revision: 20251023
Update Code: 20251023
DOI: 10.1111/ajag.70104
PMID: 41128416
Databáza: MEDLINE
Popis
Abstrakt:Introduction: The World Health Organization (WHO) launched the third Global Patient Safety Challenge: Medication without Harm in 2017, aiming to reduce avoidable medication-related harm. Recognising that medication-related harm (MRH) accounts for the highest proportion of preventable harm, this initiative remains active and evolving. This study investigates the demographic and clinical factors associated with medication-related hospital admissions among a cohort of decedents.<br />Methods: A retrospective cohort study was conducted using routinely collected non-identifiable linked data from an Australian Local Health District (LHD). The study population comprised residents aged 65 years and over who died in one of the LHD hospitals between 2017 and 2019. Logistic regression models were used to estimate unadjusted and fully adjusted odds ratios for medication-related hospital admissions.<br />Results: Among the 4353 decedents, 31%-40% experienced at least one hospital admission due to MRH in the last 5 years of life, accounting for 5% of total admissions. Higher rates of medication-related admissions were observed among individuals aged below 70 years, those residing in metropolitan areas and residential aged care facility residents. Comorbidities such as renal failure, heart failure, transient ischaemic attack, hypertension, diabetes and chronic obstructive pulmonary disease (COPD) were significant predictors of medication-related admissions.<br />Conclusions: In our cohort of decedents, one-third had at least one hospitalisation due to MRH in their final 5 years. Higher risk was associated with being under 70 years of age, living in metropolitan or aged care settings and having multiple or specific chronic conditions. These results highlight the need for targeted interventions for high-risk individuals nearing the end of life.<br /> (© 2025 AJA Inc.)
ISSN:1741-6612
DOI:10.1111/ajag.70104