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Medication-Related Factors and Hospital Readmission in Older Adults with Chronic Kidney Disease

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Tesfaye, WH, Peterson, GM ORCID: 0000-0002-6764-3882, Castelino, RL, McKercher, C ORCID: 0000-0002-7672-6743, Jose, M ORCID: 0000-0002-9589-0071, Zaidi, STR ORCID: 0000-0002-2031-1055 and Wimmer, BC ORCID: 0000-0003-3166-7126 2019 , 'Medication-Related Factors and Hospital Readmission in Older Adults with Chronic Kidney Disease' , Journal of Clinical Medicine, vol. 8 , pp. 1-12 , doi: 10.3390/jcm8030395.

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Abstract

This study aimed to examine the association between medication-related factors and riskof hospital readmission in older patients with chronic kidney disease (CKD). A retrospectiveanalysis was conducted targeting older CKD (n = 204) patients admitted to an Australian hospital.Medication appropriateness (Medication Appropriateness Index; MAI), medication regimencomplexity (number of medications and Medication Regimen Complexity Index; MRCI) and use ofselected medication classes were exposure variables. Outcomes were occurrence of readmissionwithin 30 and 90 days, and time to readmission within 90 days. Logistic and Cox hazards regressionwere used to identify factors associated with readmission. Overall, 50 patients (24%) werereadmitted within 30 days, while 81 (40%) were readmitted within 90 days. Mean time toreadmission within 90 days was 66 (SD 34) days. Medication appropriateness and regimencomplexity were not independently associated with 30- or 90-day hospital readmissions in olderadults with CKD, whereas use of renin‒angiotensin blockers was associated with reducedoccurrence of 30-day (adjusted OR 0.39; 95% CI 0.19–0.79) and 90-day readmissions (adjusted OR0.45; 95% CI 0.24–0.84) and longer time to readmission within 90 days (adjusted HR 0.52; 95% CI0.33–0.83). This finding highlights the importance of considering the potential benefits of individualmedications during medication review in older CKD patients.

Item Type: Article
Authors/Creators:Tesfaye, WH and Peterson, GM and Castelino, RL and McKercher, C and Jose, M and Zaidi, STR and Wimmer, BC
Keywords: chronic kidney disease; medication appropriateness index; medication regimen complexity index; the elderly
Journal or Publication Title: Journal of Clinical Medicine
Publisher: M D P I AG
ISSN: 2077-0383
DOI / ID Number: 10.3390/jcm8030395
Copyright Information:

Copyright 2019 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/

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