Zachary A. Marcum|Mary Jo Pugh|Megan E. Amuan|Sherrie L. Aspinall|Steven M. Handler|Christy Ruby|Joseph T. Hanlon
Prevalence of Potentially Preventable Unplanned Hospitalizations Caused by Therapeutic Failures and Adverse Drug Withdrawal Events Among Older Veterans
VA Pittsburgh Healthcare System|Geriatric Research Education and Clinical Center|University of Pittsburgh|The University of Texas Health Science Center at San Antonio|South Texas Veterans Health Care System|Edith Nourse Rogers Memorial Veterans Hospital|Medication Management (United States)|VA Pittsburgh Healthcare System|University of Pittsburgh|Geriatric Research Education and Clinical Center|University of Pittsburgh|University of Pittsburgh|VA Pittsburgh Healthcare System|Geriatric Research Education and Clinical Center|University of Pittsburgh
studies drugrelated hospitalizations focused adverse drug reactions data available therapeutic failures tfs adverse drug withdrawal events adwes leading hospitalization among communitydwelling older adults thus sought describe prevalence unplanned hospitalizations caused tfs adwes addition evaluated factors associated events nationally representative sample older veterans study included 678 randomly selected unplanned hospitalizations older age 65 years veterans december 1 2003 november 9 2006 main outcomes hospitalizations caused tf andor adwe determined pair health professionals review medication charts application therapeutic failure questionnaire andor naranjo adwe algorithm respectively preventability ie medication error admission also assessed thirtyfour tfs eight adwes involving 54 drugs associated 40 59 veterans hospitalizations admissions 900 3640 rated potentially preventable mostly due medication nonadherence suboptimal prescribing common tfs occurred heart failure exacerbations n 8 coronary heart disease symptoms n 6 tachyarrhythmias n 3 chronic obstructive pulmonary disease exacerbations n 3 half 48 adwes occurred cardiovascular nature multivariable logistic regression modeling indicated black veterans adjusted odds ratio 292 95 ci 125680 significantly likely experience tfrelated admission compared white veterans tfrelated unplanned hospitalizations occur frequently adwerelated admissions among older veterans almost tfs andor adwes potentially preventable