30-Day Hospital Readmission Risk Associated With Number of Discharge Medications

Although hospital readmissions can be difficult to predict, there is a link between the number of discharge medications prescribed to a patient and the risk of 30-day readmission, according to a study published in BMC Health Services Research.

Researchers studied 5507 patients, 1147 of which were readmitted within 30 days of discharge, at the Barnes-Jewish Hospital. They found that patients who received a greater number of discharge medications were more likely to be readmitted within 30 days.

“Polypharmacy has been identified as a risk factor for readmission for patients discharged from internal medicine services,” the authors wrote. “However, the overall impact of the number of discharge medications on hospital readmission is still undefined.”

Patients readmitted within 30 days were younger and more likely to be African American, and readmitted patients had significantly more comorbidities, such as coronary artery disease, congestive heart disease, peripheral vascular disease, chronic obstructive pulmonary disease, cirrhosis, diabetes mellitus, and metastatic cancer.

In addition, patients with a 30-day readmission had longer durations of hospitalization, more emergency department visits in the 6 months prior to their hospitalization, and were more likely to have Medicaid insurance compared with patients without a 30-day readmission.

There are 2 reasons why a larger number of discharge medications is related to readmission, according to the researchers. First, increasing medication use is likely related to disease severity, which is a good marker for readmission risk; and second, the more medications a patient is prescribed, the less likely the patient will be compliant due to either cost issues, side effects, or inability to keep track of medication use.

“The number of discharge medications was found to be associated with the prevalence of thirty-day hospital readmission,” the authors wrote. “A risk score that includes the number of discharge medications accurately predicts patients at risk for thirty-day readmission.”