In the United States the elderly make up a disproportionately large percentage of acute hospitalizations. In 2003 persons older than 65 years old made up 12% of the U.S. population but accounted for 33% of all hospitalizations. The number of hospitalized elderly will only rise over the next 40 years as the number of persons older than age 65 doubles in the United States. Medications also play an important role in the care of older adults. There use in the elderly is on the rise, with 50% taking at least 5 medications and 12% taking at least 10 medications. The objective of this study is to describe what changes occur to an elderly patient's medication regimen after an acute hospitalization.
We studied patients older than age 65 who were admitted to the hospitalist service at an urtan academic medical center. Patients had to be admitted for more than 24 hours and discharged to the oommunity. Each patient had 3 medication lists recorded, prehospitalization, at discharge and 3 days posthospitalizalion. These lists were then compared, and 4 types of differences were recorded: new medications, discontinued medications, and changes in dosage and frequency.
A total of 200 patients were studied. Preadmission they were taking a total of 1611 medications (8.1 meditations per patient). On discharge 383 medications were started (1.9 medications per patient), 168 medications were discontinued (0.8), 125 medications had a change in frequency (0.6), and 94 medications had a change in dosage (0.5). The 2 most common classes of medications added to a patient's regimen were antibiotics and anti hypertensives. Three days after discharge, patients had filled 70 of the 77 antibiotic prescriptions and 44 of the 49 antihypertensive ones. Antihypertensives and opiate agonists were the 2 most common classes of medications that were discontinued. Patients continued taking 16 of the 42 discontinued hypertensives and 7 of the 13 discontinued opiates.
Acute hospitalizelions cause on average 4 changes to an elderly patient's medication regimen. Their compliance with these changes is variable, with patients more willing to start new medications, especially antibiotics, than to discontinue chronic medications such as opiate agonists and a nti hypertensives.
A. Sridharan, none; C. Harris, none; S. Wright, none.
To cite this abstract:Sridharan A, Harris C, Wright S. Medication Changes in the Elderly during Hospitalization. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 138. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/medication-changes-in-the-elderly-during-hospitalization/. Accessed March 31, 2020.