26 August 2011


Story first appeared on Reuters.
Senior citizens with chronic medical issues often leave the hospital without prescriptions for the medicines they were getting for their illness -- a move that may raise their risk of landing in the emergency room or even dying, a study said.
Chaim Bell, of St. Michael's Hospital in Toronto, Canada, and colleagues used medical records for nearly 400,000 elderly people in Ontario to see how often those people left the hospital after a stay there without renewing prescriptions for five long-term medications.
The drugs included cholesterol-lowering statins, blood thinners, and asthma inhalers.
Bell said these are people that have been identified to have a disease and have been appropriately treated with evidence-based treatment for that disease. So these are success stories. He added that after hospitalizations they are no longer on these medications, and that's a shame.
In a study published in the Journal of the American Medical Association, the researchers then compared those who'd been admitted to a hospital with those who hadn't over the period from 1997 to 2009.
For the blood thinners, which include aspirin, as many as 19 percent of the seniors who had been hospitalized failed to get a renewed prescription within three months.
By contrast, that number was less than 12 percent for people who hadn't been admitted to the hospital.
For the other medications, the difference was less pronounced but still there, especially for those patients who landed in the intensive care unit.
While the study can't prove that hospital stays caused patients to drop their medications, Bell said he had taken measures to ensure that in most cases the discontinuation was unintentional.
The researchers also found that patients who discontinued statins and blood thinners, both of which are often used to treat heart disease, had a slightly higher risk of dying or landing in the emergency room over the next year.
Many seniors are on multiple drugs and simply may not notice that a prescription hasn't been renewed after they leave the hospital, Bell said. He said there needs to be better communications at the hospital, adding that use of electronic patient records would be a big help.
Other medical professionals note that landing in the hospital can be a good chance to adjust people's drugs and help them change their lifestyle. However, transitions of care are also a threat, especially for patients with chronic diseases and complex treatment regimens. Either because of miscommunication or simple error, patients may experience unwarranted changes in treatment with potentially deleterious effects on their health.

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