Lohman MC, et al. - This trial entailed the elucidation of the prevalence of potentially inappropriate medication (PIM) use and correlation with hospitalization among Medicare home health patients. Owing to the high prevalence of PIM use and the association between PIMs and hospitalization risk, home health episodes served as opportunities to significantly reduce PIM use among older adults and prevent adverse outcomes. The yielded data justified the endeavors to address medication use during home health episodes, hospitalizations, and care transitions.

Methods

• The scheme of this research was a cross-sectional analysis using data from 132 home health agencies in the US.
• The enrollment consisted of Medicare beneficiaries starting home health nursing services between 2013 and 2014 (n = 87,780).
• The main measure included the prevalence of individual and aggregate PIM use at start of care, determined via the 2012 Beers criteria.
• Relative risk (RR) of 30-day hospitalization or re-hospitalization associated with individual and aggregate PIM use, compared to no PIM use.

Results

• It was noted that 30,168 (34.4%) patients were using at least one PIM, with 5,969 (6.8%) taking at least two PIMs according to the Beers list.
• The most common types of PIMs were revealed to be those exerting an impact on the brain or spinal cord, analgesics, and medications with anticholinergic properties.
• PIM use across all classes correlated with elevated risk (10-33%) of hospitalization than the non-use, excluding the nonsteroidal anti-inflammatory drugs (NSAIDs).
• Patients using at least one PIM (excluding NSAIDs) exhibited a 13% greater risk (RR = 1.13, 95% CI: 1.09, 1.17) of being hospitalized than patients using no PIMs, after adjusting for demographic and clinical characteristics.
• On the other hand, patients using at least two PIMs reported a 21% greater risk (RR = 1.21, 95% CI: 1.12, 1.30).
• The data disclosed similar links between PIMs and re-hospitalization risk among patients referred to home health from a hospital.