Prevalence and incidence rate of hospital admissions related to medication between 2008 and 2013 in The Netherlands

Said, Fouzia Lghoul-Oulad; Hek, Karin; Flinterman, Linda E.; Herings, Ron M. C.; Herwaarden, Margaretha F. Warlé-van; Bie, Sandra de; Valkhoff, Vera E.; Alsma, Jelmer; Mosseveld, Mees; Vanrolleghem, Ann M.; Stricker, Bruno H. Ch.; Sturkenboom, Miriam; Smet, Peter A. G. M. De; Bemt, Patricia M. L. A. van den

doi:10.1002/pds.5122

Cited by 8 publications

(11 citation statements)

References 21 publications

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“…7,8 Because of non-adherence, patients may not benefit optimally from the therapy, which may cause morbidity, mortality, hospital admissions, and increased healthcare costs. [9][10][11][12][13][14] Adherence is often perceived as the patients' responsibility, but they can be supported by informal caregivers and primary care professionals, such as professionals from the general practice (eg, clinical nurse specialist, practice nurse, and general practitioner), pharmacy (eg, pharmacy technician and pharmacist), and home care. 15 Home care in the Netherlands involves care delivered in patients' homes by nurses of different educational levels, such as registered nurses, licensed practical nurses, and nurse aides.…”

Section: Introductionmentioning

confidence: 99%

Home Care Patients’ Experiences with Home Care Nurses’ Support in Medication Adherence

Dijkstra¹,

Vervloet²,

Sino³

et al. 2021

PPA

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Purpose To describe nurses’ support interventions for medication adherence, and patients’ experiences and desired improvements with this care. Patients and Methods A two-phase study was performed, including an analysis of questionnaire data and conducted interviews with members of the care panel of the Netherlands Patients Federation. The questionnaire assessed 14 types of interventions, satisfaction (score 0–10) with received interventions, needs, experiences, and desired improvements in nurses’ support. Interviews further explored experiences and improvements. Data were analyzed using descriptive statistics and a thematic analysis approach. Results Fifty-nine participants completed the questionnaire, and 14 of the 59 participants were interviewed. The satisfaction score for interventions was 7.9 (IQR 7–9). The most common interventions were: “noticing when I don’t take medication as prescribed” (n = 35), “helping me to find solutions to overcome problems with using medications” (n = 32), “helping me with taking medication” (n = 32), and “explaining the importance of taking medication at the right moment” (n = 32). Fifteen participants missed ≥1 of the 14 interventions. Most mentioned the following: “regularly asking about potential problems with medication use” (33%), “regularly discussing whether using medication is going well” (29%), and “explaining the importance of taking medication at the right moment” (27%). Twenty-two participants experienced the following as positive: improved self-management of adequate medication taking, a professional patient–nurse relationship to discuss adherence problems, and nurses’ proactive attitude to arrange practical support for medication use. Thirteen patients experienced the following as negative: insufficient timing of home visits, rushed appearance of nurses, and insufficient expertise about side effects and taking medication. Suggested improvements included performing home visits on time, more time for providing support in medication use, and more expertise about side effects and administering medication. Conclusion Overall, participants were satisfied, and few participants wanted more interventions. Nurses’ support improved participants’ self-management of medication taking and enabled patients to discuss their adherence problems. Adequately timed home visits, more time for support, and accurate medication-related knowledge are desired.

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Section: Introductionmentioning

confidence: 99%

Home Care Patients’ Experiences with Home Care Nurses’ Support in Medication Adherence

Dijkstra¹,

Vervloet²,

Sino³

et al. 2021

PPA

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“…However, recent studies like HYVET [2] and SPRINT [3] have shown benefits of antihypertensive therapy in older patients (> 75 years) as well. Nevertheless, older patients are known to be more susceptible to Adverse Drug Events (ADEs) of antihypertensives, which increase the risk of hospital admissions [1,[4][5][6][7]. Therefore, guidelines helping to assess the benefit-risk balance for an individual patient are highly recommended [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…A recent Dutch study showed that almost 20% of the potentially preventable medication related hospital admissions in older patients were a result of ADEs like syncope, dizziness and falls. These ADEs were mainly associated with the use of multiple antihypertensive medications [4][5][6]. In older patients, because of frailty and pharmacokinetic changes, these side effects may occur more frequently or may be more serious [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of a protocol for deprescribing antihypertensive medication in older patients in Dutch general practices

et al. 2022

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Background Older patients using antihypertensive medication may experience Adverse Drug Events (ADEs), and thus benefit from deprescribing. The lack of a practical protocol may hamper deprescribing. Therefore, we aimed to develop a deprescribing protocol, based on a review of literature, combined with a feasibility test in a small number of patients. Methods A deprescribing protocol for general practitioners was drafted and tested in older patients using multiple antihypertensive medication in a single arm intervention. Patients were included if they were 75 years or older, were using two or more antihypertensives, had at least one ADE linked to antihypertensive medication and deprescribing was considered to be safe by their general practitioner. The primary outcome was the percentage of patients for whom one or more antihypertensive drugs were stopped or reduced in dose after 12 months of follow up while maintaining safe blood pressures. Secondary outcomes were the proportion of patients reporting no ADEs after 12 months and the number of deprescribed antihypertensives. Patient’s opinions on deprescribing and enablers and barriers for study participation were also collected. Results Nine general practitioners included 14 patients to deprescribe antihypertensive medication using the deprescribing protocol. After 12 months antihypertensive drug use was lowered in 11 patients (79%). These patients had a mean systolic blood pressure increase of 16 mmHg and a mean diastolic blood pressure increase of 8 mmHg. Nine patients (64%) reported experiencing no ADEs anymore after twelve months. The mean number of deprescribed antihypertensives was 1.1 in all patients and 1.4 (range: 0.5 to 3.5) in patients who successfully lowered their medication. At baseline, being able to use less medication was the most frequently mentioned enabler to participate in this study. The most frequently mentioned positive experience at the end of the study was using less medication, which was in line with the most mentioned enabler to participate in this study. Conclusion A protocol for deprescribing antihypertensives in older patients was considered feasible, as it resulted in a substantial degree of safe deprescribing in this pilot study. Larger studies are needed to demonstrate the effect and safety of deprescribing antihypertensives in older patients.

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Section: Introductionmentioning

confidence: 99%

“…Older people are four times more likely to be admitted due to drug-related problems than younger adults [18,19]. It is estimated that DRAs account for 10-30% of all acute hospital admissions in older people, and about half of these are considered potentially preventable [19][20][21][22][23][24][25]. Similarly, the risk of drug-related readmissions is high in older people with an estimated incidence of 21% (IQR 14-23), although reported incidences vary greatly among studies due to heterogeneity in definitions and study populations [11,12,26].…”

Section: Introductionmentioning

confidence: 99%

Detectability of Medication Errors With a STOPP/START-Based Medication Review in Older People Prior to a Potentially Preventable Drug-Related Hospital Admission

et al. 2022

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Introduction Multimorbidity and polypharmacy are risk factors for drug-related hospital admissions (DRAs) in the ageing population. DRAs caused by medication errors (MEs) are considered potentially preventable. The STOPP/START criteria were developed to detect potential MEs in older people. Objective The aim of this study was to assess the detectability of MEs with a STOPP/START-based in-hospital medication review in older people with polypharmacy and multimorbidity prior to a potentially preventable DRA. Methods Hospitalised older patients (n = 963) with polypharmacy and multimorbidity from the intervention arm of the OPERAM trial received a STOPP/START-based in-hospital medication review by a pharmacotherapy team. Readmissions within 1 year after the in-hospital medication review were adjudicated for drug-relatedness. A retrospective assessment was performed to determine whether MEs identified at the first DRA were detectable during the in-hospital medication review. Results In total, 84 of 963 OPERAM intervention patients (8.7%) were readmitted with a potentially preventable DRA, of which 72 patients (n = 77 MEs) were eligible for analysis. About half (48%, n = 37/77) of the MEs were not present during the in-hospital medication review and therefore were not detectable at that time. The pharmacotherapy team recommended a change in medication regimen in 50% (n = 20/40) of present MEs, which corresponds to 26% (n = 20/77) of the total identified MEs at readmission. However, these recommendations were not implemented. Conclusion MEs identified at readmission were not addressed by a prior single in-hospital medication review because either these MEs occurred after the medication review (~50%), or no recommendation was given during the medication review * Bastiaan T. G. M. Sallevelt

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Prevalence and incidence rate of hospital admissions related to medication between 2008 and 2013 in The Netherlands

Cited by 8 publications

References 21 publications

Home Care Patients’ Experiences with Home Care Nurses’ Support in Medication Adherence

Home Care Patients’ Experiences with Home Care Nurses’ Support in Medication Adherence

Feasibility of a protocol for deprescribing antihypertensive medication in older patients in Dutch general practices

Detectability of Medication Errors With a STOPP/START-Based Medication Review in Older People Prior to a Potentially Preventable Drug-Related Hospital Admission

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