کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2508102 1402946 2016 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Changes in medication regimen complexity and the risk for 90-day hospital readmission and/or emergency department visits in U.S. Veterans with heart failure
ترجمه فارسی عنوان
تغییرات در پیچیدگی رژیم دارویی و خطر برای 90 روز بستری مجدد و/یا مراجعه به بخش اورژانس در جانبازان مبتلا به نارسایی قلبی در ایالات متحده
کلمات کلیدی
شاخص پیچیدگی رژیم دارویی؛ نارسایی قلبی؛ بستری مجدد بیمار؛ نتایج ارزیابی؛ چنددارویی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی سیاست های بهداشت و سلامت عمومی
چکیده انگلیسی

BackgroundHeart failure (HF) hospitalization is associated with multiple medication modifications. These modifications often increase medication regimen complexity and may increase the risk of readmission and/or emergency department (ED) visit.ObjectivesTo determine the association between changes in medication regimen complexity (MRC) during hospitalization of patients with heart failure and the risk of readmission or ED visit at 90 days. Secondary objectives include examining the association between changes in MRC and time to readmission as well as the relationship between number of medications and MRC.MethodsThis was a retrospective cohort study that included U.S. Veterans hospitalized with heart failure. MRC was quantified using the medication regimen complexity index (MRCI). The change in MRCI was the difference between admission MRCI and discharge MRCI recorded during the index hospitalization. Demographic and clinical data were collected to characterize the study population. Patient data for up to one year after discharge was recorded to identify hospital readmissions and ED visits.ResultsA total of 174 patients were included in the analysis. Sixty-two patients (36%) were readmitted or had an ED visit at 90 days from the index hospitalization. The mean change (SD) in MRCI during the index hospitalization among the cohort was 4.7 (8.3). After multivariate logistic regression analysis, each unit increase in MRCI score was associated with a 4% lower odds of readmission or ED visit at 90 days but this finding was not statistically significant (OR 0.955; 95% CI 0.911–1.001). In the cox proportional hazard model, the median time to hospital readmission or ED visit was 214 days. Each unit increase in MRCI score was associated with a modest but non-significant increase in probability of survival from readmission or ED visit (HR 0.978; 95% CI 0.955, 1.001).ConclusionChanges in medication regimen complexity that occur during hospitalization may also be associated with optimization of medical therapy and do not necessarily portend worse outcomes in patients with HF.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Research in Social and Administrative Pharmacy - Volume 12, Issue 5, September–October 2016, Pages 713–721
نویسندگان
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