Work

Impact of post-admission changes in potentially inappropriate medication use on risk of subsequent hospitalization among nursing home residents

Year: 2025

Type: article

Abstract: Objectives: As the population of nursing home (NH) residents grows, the management of polypharmacy and potentially inappropriate medications (PIMs) becomes crucial. Limited research exists on how changes in PIM use affect adverse outcomes, or the benefits of reducing such medications. This study explores post-admission trajectory of PIM utilization and polypharmacy, and their association with hospitalization risk. Methods: Analyzing national claims data from 23,982 seniors aged ≥65 admitted to NHs from 2008 to 2018, we assessed PIM utilization based on the 2019 Beers criteria and calculated the total number of medications prescribed during the first month of each quarter in the year following NH admission. We then used a cause-specific hazard model to explore how changes in the number of medications and PIM use were associated with the risk of hospitalization in the following 2 months. Results: Post-admission, medication and PIM use increased notably, especially in the first month, with 26% and 34% of residents experiencing increases, respectively. Deprescribing peaked in the second quarter, with 21% of residents reducing their medication use and 25% reducing PIM use. Residents with escalations in medication usage faced a 61% higher risk of hospitalization by the final quarter, while those reducing their medication count had a 21% lower risk by the second quarter. Increases in PIM use were linked to higher hospitalization risks (Quarter 1 (Q1): aHR 1.55 [1.38-1.75], Q4: aHR 1.80 [1.48-2.19]). Conversely, reductions in such use did not significantly alter hospitalization risk. Conclusion: These findings underscore the need for targeted interventions to manage polypharmacy and PIM use effectively in this population.

Source: Frontiers in Pharmacology

DOI: 10.3389/fphar.2025.1655681

Authors: Jing Zhao, Hyunwoo Chae, Young-Mi Ah, Kwanghee Jun, Ju-Yeun Lee

Institutions: Seoul National University, Yeungnam University, Gyeongsang National University

Language: English

Topic: Pharmaceutical Practices and Patient Outcomes

Subfield: Geriatrics and Gerontology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801