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Identifying older adults at increased risk of medication-related hospital readmission

Glans, Maria LU orcid ; Jakobsson, Ulf LU orcid and Midlöv, Patrik LU orcid (2024) 27th Nordic Congress of Gerontology
Abstract
Introduction
Previous studies show that approximately 40% of hospital readmissions in older adults are medication-related and that about 70% of these could be prevented. A risk assessment tool aiming to identify older adults at increased risk of medication-related readmission could help maximize the impact of implemented preventive measures and save healthcare resources. In this study we made further adjustments to our previously developed risk assessment tool (the HOME Score) aiming to increase its predictive ability as well as its clinical usefulness.

Methods
The risk assessment tool was developed through comparison of possibly medication-related readmissions (n=143) and a comparison group (n=360). Included variables... (More)
Introduction
Previous studies show that approximately 40% of hospital readmissions in older adults are medication-related and that about 70% of these could be prevented. A risk assessment tool aiming to identify older adults at increased risk of medication-related readmission could help maximize the impact of implemented preventive measures and save healthcare resources. In this study we made further adjustments to our previously developed risk assessment tool (the HOME Score) aiming to increase its predictive ability as well as its clinical usefulness.

Methods
The risk assessment tool was developed through comparison of possibly medication-related readmissions (n=143) and a comparison group (n=360). Included variables were known at first admission and individually associated with possibly medication-related readmission. Variables were assigned points, and a risk score was calculated for all individuals. A threshold score was decided on, using Youden's index, and the area under the ROC-curve (C-index) was used to measure discrimination. Sensitivity, specificity, and positive and negative predictive values were calculated.

Results
The developed risk assessment tool - the Hospitalisations, Own home, Medications, and diagnoses (HOMe+) Score - includes six variables assigned one point each. The area under the ROC-curve (C-index) is 0.733, sensitivity 81%, specificity 50%, positive predictive value 39%, and negative predictive value 87% at the threshold score (≥ 2 points).

Conclusions
The HOMe+ Score can help identify older adults in most need of preventive measures aiming to decrease the risk of medication-related hospital readmission. Further studies are needed to validate the HOMe+ Score in clinical care as well as investigate the benefits of implemented activities.
(Less)
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author
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organization
publishing date
type
Contribution to conference
publication status
published
subject
conference name
27th Nordic Congress of Gerontology
conference location
Stockholm, Sweden
conference dates
2024-06-11 - 2024-06-14
language
English
LU publication?
yes
id
22e31136-b16a-46a8-8c2b-b39214793ee5
alternative location
https://beyond-production.objects.dc-sto1.glesys.net/projects/1ee46426-e141-6518-993f-020287552602/documents/wdlpFWKe953rqzp2RdhKtTJXwrDy2nSw2kI2cc2m.html
date added to LUP
2024-06-17 15:13:53
date last changed
2024-06-27 13:38:21
@misc{22e31136-b16a-46a8-8c2b-b39214793ee5,
  abstract     = {{Introduction<br/>Previous studies show that approximately 40% of hospital readmissions in older adults are medication-related and that about 70% of these could be prevented. A risk assessment tool aiming to identify older adults at increased risk of medication-related readmission could help maximize the impact of implemented preventive measures and save healthcare resources. In this study we made further adjustments to our previously developed risk assessment tool (the HOME Score) aiming to increase its predictive ability as well as its clinical usefulness.<br/><br/>Methods<br/>The risk assessment tool was developed through comparison of possibly medication-related readmissions (n=143) and a comparison group (n=360). Included variables were known at first admission and individually associated with possibly medication-related readmission. Variables were assigned points, and a risk score was calculated for all individuals. A threshold score was decided on, using Youden's index, and the area under the ROC-curve (C-index) was used to measure discrimination. Sensitivity, specificity, and positive and negative predictive values were calculated.<br/><br/>Results<br/>The developed risk assessment tool - the Hospitalisations, Own home, Medications, and diagnoses (HOMe+) Score - includes six variables assigned one point each. The area under the ROC-curve (C-index) is 0.733, sensitivity 81%, specificity 50%, positive predictive value 39%, and negative predictive value 87% at the threshold score (≥ 2 points).<br/><br/>Conclusions<br/>The HOMe+ Score can help identify older adults in most need of preventive measures aiming to decrease the risk of medication-related hospital readmission. Further studies are needed to validate the HOMe+ Score in clinical care as well as investigate the benefits of implemented activities.<br/>}},
  author       = {{Glans, Maria and Jakobsson, Ulf and Midlöv, Patrik}},
  language     = {{eng}},
  month        = {{06}},
  title        = {{Identifying older adults at increased risk of medication-related hospital readmission}},
  url          = {{https://beyond-production.objects.dc-sto1.glesys.net/projects/1ee46426-e141-6518-993f-020287552602/documents/wdlpFWKe953rqzp2RdhKtTJXwrDy2nSw2kI2cc2m.html}},
  year         = {{2024}},
}