Potentially inappropriate medications (PIMs) pose greater risk of harm than benefit, especially when prescribed for patients aged 65 years and over. Hospitalisation provides an opportunity for medication review – while some PIMs are deprescribed or replaced during the hospital stay, new PIMs may also be prescribed at discharge. A recent Canadian study has prospectively assessed the impact of PIMs prescribed at discharge on adverse effects post-hospitalisation. 2,402 patients aged 65 years and over (median age 76 years) were included in the study. 66% were prescribed at least one PIM at discharge, 49% continued a PIM they used prior to hospitalisation and 31% were prescribed at least one new PIM at the time of leaving hospital. During the 30-day follow up period, 9% experienced an adverse drug event (ADE) and 36% visited an emergency department (ED), were rehospitalised, or died. Each new PIM and continued community PIM were significantly associated with an increased risk of ADEs, ED visits, rehospitalisation and death. A large proportion of patients were prescribed a PIM at discharge and the associated increase in risk for all-cause adverse events emphasizes the importance of improving and optimising hospital prescribing practices. Details of this study can be viewed here.
Contributed by Australian Medication Safety Services Associate – Isabella Singh