Changes in drug therapy following hospital discharge for patients in a general practice: a German incident study

Müller-Bühl, U; Gerold, C.; Engeser, Peter; Szécsényi, Joachim

doi:10.1007/s10389-008-0241-6

Cited by 8 publications

(6 citation statements)

References 25 publications

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“…Findings from our study show that changes to antihypertensive pharmacotherapy among older inpatients were common, echoing findings of previous studies [ 21 , 22 ]. Similar to findings by Wang et al [ 23 ] we found that the number of antihypertensive medications decreased following hospitalization.…”

Section: Discussionsupporting

confidence: 90%

Impact of Hospitalization on Antihypertensive Pharmacotherapy among Older Persons

Alhawassi

Krass

Pont

2015

Drugs - Real World Outcomes

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BackgroundLittle is known about the impact of hospitalization on antihypertensive pharmacotherapy and blood pressure control in older persons.ObjectivesThe aim of this study was to explore the impact of hospitalization on the management of hypertension and antihypertensive pharmacotherapy in a cohort of older patients with a documented diagnosis of hypertension.MethodsA retrospective, cross-sectional medical record audit was conducted in a large Australian metropolitan teaching hospital. Patients aged 65 years or older, admitted between January 1st 2010 and December 31st 2010, and with a documented diagnosis of hypertension in their medical record were included in the study. Antihypertensive pharmacotherapy and blood pressure control was compared between admission and discharge. Factors associated with changes to antihypertensive pharmacotherapy were identified.ResultsChanges to antihypertensive pharmacotherapy occurred in 39.5 % (n = 135) of patients (n = 342). On discharge, the proportion of patients receiving antihypertensive pharmacotherapy (89.0 vs 85.3 %, p < 0.0001) and the mean number of antihypertensive agents per patient (1.7 ± 1.1 vs 1.5 ± 1.1, p < 0.0001) declined compared with admission. Adverse drug reactions [odds ratio (OR) = 5, 95 % confidence interval (CI): 2.80–9.34] were the main reason documented for antihypertensive pharmacotherapy changes. Patients admitted under the care of medical (OR = 0.3, 95 % CI: 0.17–0.70) or surgical (OR = 0.3, 95 % CI: 0.12–0.53) specialties were less likely to experience changes to their antihypertensive pharmacotherapy than those treated by gerontology or cardiology teams.ConclusionsHospitalization has a significant impact on antihypertensive pharmacotherapy. Two out of every five older persons on antihypertensive medications will experience changes to their regimens during admission to hospital with most changes in antihypertensive pharmacotherapy due to adverse drug reactions.

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Section: Discussionsupporting

confidence: 90%

Impact of Hospitalization on Antihypertensive Pharmacotherapy among Older Persons

Alhawassi

Krass

Pont

2015

Drugs - Real World Outcomes

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“…Müller‐Bühl et al . have shown that in the practice setting in Germany, only 19·4% of the proposed hospital drug medication was issued unchanged.…”

Section: Resultsmentioning

confidence: 99%

Providing systematic detailed information on medication upon hospital discharge as an important step towards improved transitional care

et al. 2014

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“…Microscopic studies have shown that specialists, in particular hospitalists, influence the prescribing behaviour of general practitioners (GP), directly by initiating treatments or indirectly by informing GPs about drugs [1][2][3][4][5][6][7][8][9][10][11]. Hospitalization of patients is also the occasion to take stock of their drug regimen and very frequently results in changes in medications [12][13][14][15][16][17][18][19][20][21]. However, some modifications are not clinically motivated and are only made to match the hospital formulary.…”

Section: Introductionmentioning

confidence: 99%

The influence of drug use in university hospitals on the pharmaceutical consumption in their surrounding communities

Gallini

Taboulet

2013

Brit J Clinical Pharma

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Aim To investigate the influence of hospital drug choices on pharmaceutical consumption for nine competitive classes in the surrounding community. Methods Ecological study. Data from the national survey on drugs in hospitals were used to extract quantities purchased by 25 French university hospitals for three ‘hospital classes’ (EPOs, LMWHs and setrons) and six ‘ambulatory classes’ (PPIs, ACEIs and ARBs, statins, α‐adrenoreceptor antagonists (AAAs) and selective serotonin re‐uptake inhibitors SSRIs). Re‐imbursed quantities for patients living in the hospital's catchment area were extracted from the national health insurance database. The relationship between the use of a brand in hospitals and their catchment areas was assessed using multivariate linear regressions with instrumental variables. Results An increase of 1 day of treatment with one brand in the hospital was associated with a significant increase of 2.8 days of treatment with the same brand in the catchment area. However, results strongly varied according to classes. An increase of 1 day of treatment in the hospital was significantly associated with an increase of 0.21 day for ‘hospital classes’ and 21.8 days for ‘ambulatory classes’ in the catchment area. Strong variations were seen across ‘ambulatory classes’. The effect was maximal for cardiovascular classes and not significant for AAAs and SSRIs. The size of the effect also varied with hospital characteristics: small and proximity university hospitals exerted the greatest influence. Conclusions Hospital consumption influences the use of drugs in the community. A significant effect was found, especially for competitive classes used on a long‐term basis. The economic consequences of these findings need to be addressed.

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Changes in drug therapy following hospital discharge for patients in a general practice: a German incident study

Abstract: Objective

Cited by 8 publications

References 25 publications

Impact of Hospitalization on Antihypertensive Pharmacotherapy among Older Persons

Impact of Hospitalization on Antihypertensive Pharmacotherapy among Older Persons

Providing systematic detailed information on medication upon hospital discharge as an important step towards improved transitional care

The influence of drug use in university hospitals on the pharmaceutical consumption in their surrounding communities

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