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Can Doctors Identify Older Patients at Risk of Medication Harm Following Hospital Discharge?

Medication-related harm (MRH) is common in older adults following hospital discharge. A new British Journal of Clinical Pharmacology study has examined whether doctors can predict which older patients will experience MRH requiring care following hospital discharge, and whether clinical experience and confidence in prediction influence the accuracy of predictions.

Monday, July 2, 2018 5:16 am EDT
"These findings confirm the complexity of predicting medication-related harm. This makes it very challenging to target medication-related strategies to the right individuals"

Medication-related harm (MRH) is common in older adults following hospital discharge. A new British Journal of Clinical Pharmacology study has examined whether doctors can predict which older patients will experience MRH requiring care following hospital discharge, and whether clinical experience and confidence in prediction influence the accuracy of predictions. 

The study found that clinical judgement of doctors is not a reliable tool to predict MRH in older adults post-discharge.

In the multicentre observational prospective study involving five teaching hospitals in England between September 2013 and November 2015, there were 1066 patients with completed predictions and follow-up. Doctors discharging older patients from medical wards predicted the likelihood of their patient experiencing MRH requiring care in the initial 8 week period post-discharge.

Most predictions (85%) were made by junior doctors with less than 5 years’ clinical experience. There was no relationship between doctors’ predictions and patient MRH, irrespective of years of clinical experience. Doctors’ predictions were more likely to be accurate when they reported higher confidence in their prediction, especially in predicting MRH-associated hospital readmissions.

“These findings confirm the complexity of predicting medication-related harm. This makes it very challenging to target medication-related strategies to the right individuals,” said Dr. Khalid Ali, chief investigator of the study and senior lecturer in Geriatrics at Brighton and Sussex Medical School. “Clinical pharmacology and therapeutics teaching has not been particularly prominent in undergraduate medical training. This is perhaps an area requiring review, given an ageing population that is prescribed ever increasing quantities of medicine.” Dr. Ali added that there is a need to consider new approaches to identify individuals at high risk of medication-related harm given its serious impact on patients and health care services.

Additional Information

URL Upon Publication: http://onlinelibrary.wiley.com/doi/10.1111/bcp.13690 

About the Journal

The British Journal of Clinical Pharmacology has the primary goal of publishing high quality research papers on all aspects of drug action in humans. The journal has a wide readership, bridging the medical profession, clinical research and the pharmaceutical industry, and is published monthly. It is owned by the British Pharmacological Society and published by Wiley. The journal’s current Impact Factor is 3.493 (Thomson Reuters Science Citation Index).

About The British Pharmacological Society

The British Pharmacological Society is a charity with a mission to promote and advance the whole spectrum of pharmacology. Founded in 1931, it is now a global community at the heart of pharmacology, with over 3,500 members from more than 60 countries worldwide. The Society leads the way in the research and application of pharmacology around the world through its scientific meetings, educational resources and peer-reviewed journals: the British Journal of Clinical PharmacologyPharmacology Research & Perspectives, and the British Journal of Pharmacology, which includes the Concise Guide to PHARMACOLOGY, featuring open access overviews of the key properties of over 1,700 human therapeutic targets and their drugs, and links to www.guidetopharmacology.org.

Press Office: T. +44 (0) 207 239 0180  E. david.adams@bps.ac.uk

About Wiley 

Wiley, a global research and learning company, helps people and organizations develop the skills and knowledge they need to succeed. Our online scientific, technical, medical, and scholarly journals, combined with our digital learning, assessment and certification solutions help universities, learned societies, businesses, governments and individuals increase the academic and professional impact of their work. For more than 210 years, we have delivered consistent performance to our stakeholders. The company's website can be accessed at www.wiley.com.

Peer Reviewed, Prospective Study, Human

 

 

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sciencenewsroom@wiley.com

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