5PSQ-079 Continued use of potentially inappropriate medication after hospital discharge: a retrospective cohort study
Year: 2025
Type: conference-paper
Study design: Observational Study
Abstract: Background and Importance Many patients receive temporarily indicated medications when they are hospitalised, e.g. opioids, benzodiazepines and/or antipsychotics. When such medications are continued at hospital discharge, it can result in potentially inappropriate medication (PIM) use post-discharge. However, there are no data available about continued use of PIMs at home in the Netherlands. Aim and Objectives Therefore, the aim was to investigate the incidence of continued use of in hospital-initiated opioids, benzodiazepines, and antipsychotics post-discharge in the Netherlands. Material and Methods A retrospective cohort study was conducted in a Dutch teaching hospital. Patients aged ≥18 years and discharged from the hospital between January 2019 to May 2023 with a new prescription of an opioid, benzodiazepine or antipsychotic started during hospitalisation and continued at discharge, were included and followed-up for 1 year. Data from the hospital information system and dispensing records of community pharmacies (Nationwide Medication Record System) were used to identify patients who continued use post-discharge. Primary outcomes of this study were the incidence of continued PIMs prescriptions post-discharge for each of the medication classes of interest and duration of use. Duration of use was classified into <30 days, 30–182 days and >182 days. Descriptive statistics were used to analyse the data. Results Among 6,835 patients with a new prescription of one of the study medications, 82.7% were prescribed and dispensed an opioid at discharge (n=5,652, mean age 61.1 years, 57.3% female), 14.7% a benzodiazepine (n=1,005, mean age 60.7 years, 53.3% female) and 2.6% an antipsychotic (n=178, mean age 69.2 years, 48.9% female). 62.5% of new benzodiazepine users, 73.4% of new opioid users and 42.1% of new antipsychotic users had a duration of continued use of <30 days post-discharge. A substantial number of patients had a duration of PIM use >182 days post-discharge (13.4% of opioid, 20.9% of benzodiazepine and 36.0% of antipsychotic medication users). Conclusion and Relevance This study found that antipsychotics were most often continued >182 days post-discharge, followed by benzodiazepines and opioids. These results highlight the importance of recognising PIMs and emphasise the need for careful evaluation of discontinuing these medications at hospital discharge or specifying a discontinuation date. References and/or Acknowledgements Conflict of Interest No conflict of interest
Language: English
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4408376326