Patterns and Predictors of Medication Change after Discharge from Hospital: An Observational Study in Older Adults with Neurological Disorders
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting and Participantss
2.2. Statistical Analysis
3. Results
3.1. Clinical and Demographical Characteristics
3.2. Patterns of Medication Changes after Discharge
3.3. Predictors of General Medication Changes after Discharge
3.4. Predictors of Patient-Initiated Medication Changes after Discharge
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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n | Medication Change: Yes (n = 204) | Medication Change: No (n = 518) | p | |
---|---|---|---|---|
% (Frequency) | % (Frequency) | |||
sex | 910 | 0.99 1 | ||
male | 58.3% (119/204) | 58.3% (302/518) | ||
female | 41.7% (85/204) | 41.7% (216/518) | ||
Education level | 896 | 0.42 1 | ||
High | 36.2% (72/199) | 34.8% (179/513) | ||
Middle | 31.6% (63/199) | 36.6% (188/513) | ||
Low | 32.2% (64/199) | 28.6% (146/513) | ||
Diagnosis group | 910 | 0.71 1 | ||
movement disorder | 34.3% (70/204) | 35.5% (184/518) | ||
cerebrovascular disorder | 27.9% (57/204) | 23.1% (120/518) | ||
Epilepsy | 4.4% (9/204) | 4.4% (23/518) | ||
neuromuscular | 18.1% (37/204) | 18.9% (98/518) | ||
Others | 15.2 (31/204) | 17.9 (93/518) | ||
BFI | 843 | 0.55 1 | ||
Neuroticism | 15.3% (28/182) | 10.7% (51/476) | ||
Openness | 13.7% (25/182) | 16.1% (77/476) | ||
Conscientiousness | 42.3% (77/182) | 44.3% (211/476) | ||
Extraversion | 20.8% (38/182) | 21.0% (100/476) | ||
Agreeableness | 7.6% (14/182) | 7.7% (37/476) | ||
Medication change in the last 6 months: yes | 844 | 52.7% (95/180) | 44.1% (212/480) | 0.05 1 |
Q1 Mdn Q3 | Q1 Mdn Q3 | p | ||
Age | 910 | 84.0 71.0 78.0 | 63.0 70.0 77.0 | 0.41 2 |
TuG | 585 | 8.0 9.0 11.0 | 8.0 9.0 11.0 | 0.67 2 |
Frequency of doctor appointments (quarterly) | 838 | 1.0 1.0 3.0 | 1.0 1.0 3.0 | 0.78 2 |
BDI | 909 | 6.0 9.2 15.0 | 4.0 8.0 14.0 | <0.01 2 |
MoCA | 910 | 22.0 24.0 25.0 | 22.0 23.0 26.0 | 0.84 2 |
SAMS | 755 | 1.0 5.0 10.0 | 1.0 4.0 8.0 | 0.01 2 |
Number of Medications | 910 | 1.0 5.0 9.6 | 1.0 4.0 8.0 | 0.01 2 |
HCCQ | 831 | 5.0 5.7 6.4 | 5.1 5.9 6.4 | 0.24 2 |
SF36 | ||||
Physical functioning | 903 | 18.3 45.0 70.0 | 25.0 50.0 75.0 | 0.02 2 |
Social functioning | 907 | 50.0 75.0 100.0 | 50.0 75.0 100.0 | 0.75 2 |
Role limitations due to physical health | 874 | 0.0 0.0 75.0 | 0.0 0.0 75.0 | 0.91 2 |
Role limitations due to emotional problem | 875 | 0.0 100.0 100.0 | 0.0 100.0 100.0 | 0.28 2 |
Emotional well-being | 899 | 52.0 68.0 80.0 | 52.0 68.0 80.0 | 0.68 2 |
Energy/fatigue | 899 | 30.0 45.0 60.0 | 35.0 50.0 65.0 | 0.12 2 |
Pain | 907 | 22.4 44.9 77.6 | 32.7 55.1 77.7 | 0.24 2 |
General health | 896 | 35.0 45.0 55.0 | 35.0 45.0 55.0 | 0.35 2 |
Health change | 899 | 0.0 25.0 50.0 | 25.0 25.0 50.0 | 0.01 2 |
Physical Health component score | 849 | 24.2 33.1 41.0 | 26.6 33.7 43.0 | 0.20 2 |
Mental Health component score | 849 | 38.7 50.4 57.1 | 39.5 51.0 57.4 | 0.81 2 |
Step | 95% Confidence Interval | Nagelkerkes R2 | ||||||
---|---|---|---|---|---|---|---|---|
Exp(B) | Lower CI | Upper CI | χ2 | df | Sig. | |||
1 | BDI | 1.011 | 0.987 | 1.035 | 0.020 | 9.568 | 4 | 0.048 |
Number of pills/day | 0.997 | 0.949 | 1.047 | |||||
Physical functioning | 0.995 | 0.989 | 1.002 | |||||
Health change | 0.994 | 0.987 | 1.001 | |||||
Constant | 0.549 | |||||||
2 | BDI | 1.011 | 0.987 | 1.035 | 0.020 | 9.553 | 3 | 0.023 |
Physical functioning | 0.995 | 0.989 | 1.002 | |||||
Health change | 0.994 | 0.987 | 1.001 | |||||
Constant | 0.539 | |||||||
3 | Physical functioning | 0.995 | 0.989 | 1.000 | 0.019 | 8.784 | 2 | 0.012 |
Health change | 0.993 | 0.986 | 1.001 | |||||
Constant | 0.634 |
Physician-Initiated | Patient-Initiated | p | ||||||||
n | % | n | % | |||||||
Sex | female | 41 | 29.9% | 16 | 11.7% | 0.012 | ||||
male | 71 | 51.8% | 9 | 6.6% | ||||||
Medication change | no | 39 | 34.2% | 8 | 7.0% | 0.196 | ||||
yes | 61 | 53.5% | 6 | 5.3% | ||||||
Diagnosis | Movement disorder | 184 | 25.5% | 70 | 9.7% | 0.714 | ||||
cerebrovascular disorder | 120 | 16.6% | 57 | 7.9% | ||||||
epilepsy | 23 | 3.2% | 9 | 1.2% | ||||||
neuromuscular | 98 | 13.6% | 37 | 5.1% | ||||||
others | 93 | 12.9% | 31 | 4.3% | ||||||
Education level | high | 45 | 33.6% | 7 | 5.2% | 0.469 | ||||
middle | 36 | 26.9% | 10 | 7.5% | ||||||
low | 28 | 20.9% | 8 | 6.0% | ||||||
M | SD | Lower 95% CI (M) | Upper 95% CI (M) | M | SD | Lower 95% CI (M) | Upper 95% CI (M) | p | ||
Age | 70.5 | 9.4 | 68.7 | 72.3 | 72.8 | 6.7 | 70.1 | 75.6 | 0.263 | |
Number of pills/day | 5.8 | 3.7 | 5.1 | 6.5 | 6.0 | 4.1 | 4.3 | 7.7 | 0.840 | |
BDI | 11.3 | 7.3 | 9.9 | 12.6 | 12.9 | 7.0 | 10.0 | 15.9 | 0.206 | |
HCCQ-D | 5.5 | 1.0 | 5.3 | 5.7 | 5.2 | 1.6 | 4.3 | 6.2 | 0.829 | |
MoCA | 23.7 | 2.4 | 23.2 | 24.1 | 24.1 | 2.2 | 23.2 | 25.0 | 0.313 | |
Frequency of doctor appointments (quarterly) | 2.1 | 3.0 | 1.5 | 2.7 | 1.4 | 0.9 | 0.9 | 1.9 | 0.760 | |
SAMS total | 7.0 | 7.2 | 5.7 | 8.4 | 6.4 | 6.2 | 3.8 | 8.9 | 0.621 |
Others | Side Effects | Missing Effects | Sign. | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | χ2 | ||||||||
Sex | female | 48 | 24.2% | 21 | 10.6% | 13 | 6.6% | 0.655 | ||||||
male | 75 | 37.9% | 24 | 12.1% | 17 | 8.6% | ||||||||
Diagnosis group | movement disorder | 32 | 16.2% | 19 | 9.6% | 17 | 8.6% | 0.082 | ||||||
cerebrovascular disorder | 38 | 19.2% | 11 | 5.6% | 7 | 3.5% | ||||||||
epilepsy | 7 | 3.5% | 1 | 0.5% | 0 | 0.0% | ||||||||
neuromuscular | 25 | 12.6% | 6 | 3.0% | 4 | 2.0% | ||||||||
others | 21 | 10.6% | 8 | 4.0% | 2 | 1.0% | ||||||||
Education Level | high | 47 | 24.4% | 12 | 6.2% | 13 | 6.7% | 0.145 | ||||||
middle | 39 | 20.2% | 14 | 7.3% | 12 | 6.2% | ||||||||
low | 34 | 17.6% | 18 | 9.3% | 4 | 2.1% | ||||||||
M | SD | 95%CI | 95%CI | M | SD | 95%CI | 95%CI | M | SD | 95%CI | 95%CI | p | ||
Age | 69.7 | 8.7 | 68.1 | 71.2 | 71.8 | 8.1 | 69.4 | 74.2 | 71.0 | 9.3 | 67.5 | 74.5 | <0.05 | |
Number of pills/day | 5.8 | 3.7 | 5.1 | 6.5 | 5.6 | 3.9 | 4.5 | 6.8 | 5.6 | 3.8 | 4.2 | 7.1 | <0.05 | |
BDI | 10.5 | 6.7 | 9.3 | 11.7 | 10.8 | 7.4 | 8.6 | 13.0 | 15.2 | 9.3 | 11.6 | 18.7 | <0.05 | |
HCCQ-D | 5.6 | 1.0 | 5.4 | 5.7 | 5.5 | 1.2 | 5.2 | 5.9 | 5.0 | 1.6 | 4.3 | 5.8 | <0.05 | |
MoCA | 23.6 | 2.6 | 23.1 | 24.1 | 23.8 | 2.7 | 23.0 | 24.6 | 23.8 | 2.2 | 23.0 | 24.7 | <0.05 | |
Frequency of doctor appointments (quarterly) | 2.0 | 2.8 | 1.5 | 2.5 | 2.7 | 2.9 | 1.8 | 3.6 | 1.7 | 1.5 | 1.1 | 2.4 | <0.05 | |
SAMS total | 7.5 | 7.7 | 6.1 | 8.8 | 5.4 | 5.6 | 3.7 | 7.1 | 6.4 | 6.5 | 3.9 | 8.8 | <0.05 |
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Schwarzkopf, A.; Schönenberg, A.; Prell, T. Patterns and Predictors of Medication Change after Discharge from Hospital: An Observational Study in Older Adults with Neurological Disorders. J. Clin. Med. 2022, 11, 563. https://doi.org/10.3390/jcm11030563
Schwarzkopf A, Schönenberg A, Prell T. Patterns and Predictors of Medication Change after Discharge from Hospital: An Observational Study in Older Adults with Neurological Disorders. Journal of Clinical Medicine. 2022; 11(3):563. https://doi.org/10.3390/jcm11030563
Chicago/Turabian StyleSchwarzkopf, Anna, Aline Schönenberg, and Tino Prell. 2022. "Patterns and Predictors of Medication Change after Discharge from Hospital: An Observational Study in Older Adults with Neurological Disorders" Journal of Clinical Medicine 11, no. 3: 563. https://doi.org/10.3390/jcm11030563