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Which Potentially Inappropriate Medications List Can Detect Patients At Risk of Readmissions in the Older Adult Population Admitted for Falls? An Observational Multicentre Study Using a Clinical Data Warehouse

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Abstract

Background and Objective

Hospital readmissions are common in the older adult population and potentially inappropriate medications are known to be involved in these readmissions. Several lists of potentially inappropriate medications have been published in diverse countries in order to adapt the lists to local specificities. Among them, the Beers Criteria® were first published in 1991 in the USA, followed by the French Laroche list, the Norwegian NORGEP criteria, the German PRISCUS list, the Austrian consensus panel list and the European list, EU-7. The main objective was to detect which potentially inappropriate medications list can better detect hospital readmissions within 30 days in the older adult population hospitalised for fall-related injuries.

Methods

We conducted a multicentre, observational, retrospective cohort study. Data from older patients initially hospitalised for falls in 2019 and discharged home were retrieved from the Clinical Data Warehouse. Exposure to potentially inappropriate medications was classified according to the six lists mentioned above. The local ethics committee approved the study protocol (number CER-2020-79).

Results

After adjustments using propensity score matching, taking a potentially inappropriate medication as per the Laroche and PRISCUS lists was associated with a 30-day hospital readmission with an odds ratio of 1.58 (95% confidence interval 1.06–2.37) and 1.68 (95% confidence interval 1.13–2.50), respectively, while the other four studied lists showed no associations with readmissions.

Conclusions

Our study evidenced that not all lists published allow the accurate prediction of hospital readmissions to the same extent. We found that the Laroche and PRISCUS lists were associated with increased 30-day all-cause hospital readmissions after an index admission with a fall-related injury.

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Acknowledgements

We gratefully acknowledge the kind assistance of Stella Ghouti, qualified translator.

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Authors and Affiliations

  1. GHU AP-HP, Sorbonne Université, Hôpital Saint Antoine, Pharmacie, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France

    Rouba Assi, Camille Schwab, Asmae El Abd, Christine Fernandez & Patrick Hindlet

  2. Département de Pharmacie Clinique, Faculté de Pharmacie, Université Paris-Saclay, Chatenay-Malabry, France

    Camille Schwab, Christine Fernandez & Patrick Hindlet

Authors
  1. Rouba Assi
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  2. Camille Schwab
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  3. Asmae El Abd
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  4. Christine Fernandez
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  5. Patrick Hindlet
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Corresponding author

Correspondence to Camille Schwab.

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Funding

This research did not receive any funding from agencies in the public, commercial or not-for-profit sectors.

Conflict of interest

The authors state that they have no conflicts of interest.

Ethics Approval

The local ethic committee approved the study protocol (number CER-2020-79).

Consent to Participate

Not applicable.

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Not applicable.

Availability of Data and Material

Data is available upon request.

Code Availability

Code is available upon request.

Author Contributions

Substantial contributions to the conception and design, or acquisition of data, or analysis and interpretation of data: RA, CS, CF, PH. Drafting the article or revising it critically for important intellectual content: RA, AEA, CS, CF, PH.

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Assi, R., Schwab, C., El Abd, A. et al. Which Potentially Inappropriate Medications List Can Detect Patients At Risk of Readmissions in the Older Adult Population Admitted for Falls? An Observational Multicentre Study Using a Clinical Data Warehouse. Drugs Aging 39, 175–182 (2022). https://doi.org/10.1007/s40266-022-00921-6

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  • DOI: https://doi.org/10.1007/s40266-022-00921-6

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