Discontinuation of medications higher in patients with ICU admissions than in non-ICU admissions
TUESDAY, Aug. 23 (HealthDay News) -- Hospital or intensive care unit (ICU) admission is associated with unintentional discontinuation of medication for chronic diseases, according to a study published online Aug. 23 in the Journal of the American Medical Association.
Chaim M. Bell, M.D., Ph.D., from St. Michael's Hospital in Canada, and colleagues investigated the rate of potentially unintentional discontinuation of medications following hospital or ICU admission from 1997 to 2009 among 187,912 patients aged 66 years or older. Prior to admission, the participants were using any one of the five evidence-based medication groups prescribed for long-term use: statins, antiplatelet/anticoagulant agents, levothyroxine, respiratory inhalers, and gastric acid-suppressing drugs. Rates of medication discontinuation were compared between patients hospitalized to ICU, hospitalized without ICU, and non-hospitalized patients (208,468 controls). Odds ratios (ORs) were calculated after adjustments. Failure to renew the prescription within 90 days after hospital discharge was the main outcome measure. The patients were followed up for one year.
The investigators found that for all medication groups, patients admitted to the hospital were more likely than controls to experience unintentional discontinuation of medications. Compared to hospitalizations without an ICU admission, admission to an ICU correlated with an additional risk of medication discontinuation in four of the five medication groups. An elevated adjusted OR of 1.07 and 1.10 was observed for the secondary composite outcome of death, emergency department visit, or emergent hospitalization one year after discontinuing statins and antiplatelet/anticoagulant agents, respectively.
"Patients prescribed medications for chronic diseases were at risk for potentially unintentional discontinuation after hospital admission. Admission to the ICU was generally associated with an even higher risk of medication discontinuation," the authors write.
Two of the study authors disclosed financial ties with the pharmaceutical industry.
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