Journal Article

Are Lists of Potentially Inappropriate Medications Associated with Hospital Readmissions? A Systematic Review

Dechartres, Agnès, Schwab, Camille, Fernandez, Christine, Clementz, Alice, Hindlet, Patrick

2024

Overview

Background Suboptimal prescribing, including the prescription of potentially inappropriate medications (PIM), is frequent in patients aged 65 years and older. PIMs are associated with adverse drug events, which may lead to hospital admissions and readmissions for the most serious cases. Several tools, known as lists of PIMs, can detect suboptimal prescription. Objective This systematic review aimed to identify which lists of PIMs are associated with hospital readmission of older patients. Patients and Methods MEDLINE, the Cochrane Library, EMBASE, and clinicaltrials.gov were searched for the period from 1 January 1991 up to 12 May 2022 to identify original studies assessing the association between PIMs and hospital readmissions or emergency department (ED) revisits within 30 days of discharge in older patients. This study is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Checklist, and the risk of bias was assessed with the Newcastle–Ottawa Quality Assessment Scale for Cohort Studies (NOS) and the revised Cochrane risk-of-bias tool for randomized trials (RoB 2). Results A total of six studies presenting four different lists of PIMs were included. Readmission rates varied from 4.3 to 25.5% and the odds ratio (OR) between PIMs and hospital readmission varied from 0.92 [95% confidence interval (CI) 0.59; 1.42] to 6.48 [95% CI 3.00; 14.00]. Only two studies found a statistically significant association between a list of PIMs and hospital readmission. These two studies used different tools: the Screening Tool of Older Person’s Prescriptions (STOPP) and the Screening Tool to Alert Doctors to Right Treatment (START) and a combination of Beers Criteria® and STOPP and START. Conclusion This systematic review shows that the association between list of PIMs and 30-day unplanned readmissions remains unclear and seems dependent on the PIM detection tool. Further studies are needed to clarify this association. PROSPERO registration number CRD42021252107.

• Publisher: Springer International Publishing,Springer Nature B.V,Adis
• Subject: Aged / Bias / Cohort analysis / CRD / CRD42021252107 / Data collection / Emergency medical care / Geriatrics/Gerontology / Hospitals / Humans / Inappropriate Prescribing - statistics & numerical data / Internal Medicine / Length of stay / Life Sciences / Medical databases / Medicine / Medicine & Public Health / Mortality / Older people / Patient admissions / Patient Readmission - statistics & numerical data / Pharmacology/Toxicology / Pharmacotherapy / Potentially Inappropriate Medication List - statistics & numerical data / Prescriptions / Santé publique et épidémiologie / Systematic Review