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Jamil M, Sweed H, Abou-Hashem R, Hamed H, Ali K. 1283 MEDICATION-RELATED HARM (MRH) IN OLDER PEOPLE AFTER LEAVING HOSPITAL - AN UNDER-REPORTED EGYPTIAN CHALLENGE. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Introduction
Ageing is associated with multimorbidity, polypharmacy and medication-related harm (MRH). A 2013 systematic review reported only one study of medication errors (MEs) in older Egyptian patients. Our study investigated MRH (adverse drug reactions (ADR), drug errors, and non-adherence) in older Egyptian adults after hospital-discharge.
Methods
Between 2018 and 2020, we recruited 400 Egyptian patients, aged ≥60 years on discharge from Geriatrics and Internal Medicine wards from 3 hospitals, and followed them up for 8 weeks. Study procedures adopted a modified PRIME trial methodology (1).
Results
The average age of study participants was 71 (range 60 to 93, SD +/- 6.29) years with 53% females. In the cohort of 325 patients completing follow up, MRH occurred in 99 patients (incidence of 30.5%), with 5 patients (5.1%) experiencing a fatal MRH. Almost two thirds (65.7%) of MRH events were secondary to ADRs, 2 % related to non-adherence, 18.2 % due to both ADR and non-adherence, and 14% related to MEs. Multivariate logistic regression analysis showed that non-adherence (p-value 0.000, OR- 95% CI: 36.029), inappropriate prescription using Beer’s criteria (p 0.000, OR- 95% CI: 6.589), length of stay >7days (p 0.001, OR- 95% CI: 6.176), presence of Ischaemic Heart Disease (IHD) (p 0.000,OR- 95% CI: 5.695), Platelets count ≤ 245X 109/L (p 0.021, OR- 95% CI: 2.640), and dementia medications (p 0.017, OR- 95% CI: 4.616) were all significantly associated with MRH.
Conclusions
Medication-related harm in older Egyptian adults is common after hospital discharge. An integrated care pathway is required targeting high-risk older patients.
Reference
1. Stevenson J, Parekh N, Ali K et al. Protocol for a Prospective (P) study to develop a model to stratify the risk (RI) of medication (M) related harm in hospitalized elderly (E) patients in the UK (The PRIME study). BMC Geriatrics 2016; 16: 22. https://doi.org/10.1186/s12877-016-0191-8.
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Affiliation(s)
- M Jamil
- Ain Shams University Geriatrics and Gerontology Department, , Egypt
| | - H Sweed
- Ain Shams University Geriatrics and Gerontology Department, , Egypt
| | - R Abou-Hashem
- Ain Shams University Geriatrics and Gerontology Department, , Egypt
| | | | - K Ali
- Brighton and Sussex Medical School Academic Department of Geriatrics, , UK
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