HIGH-RISK MEDICATIONS AND UNPLANNED HOSPITALIZATIONS- A CASE–TIME–CONTROL STUDY
Author(s)
Lin C1, Wen Y2, Chen L3, Hsiao F1
1National Taiwan University, Taipei, Taiwan, 2Chang Gung University, Taoyuan, Taiwan, 3Taipei Veterans General Hospital, Taipei, Taiwan
OBJECTIVES: Empirical data of medication-related hospitalization are very limited. The aim of this study is to investigate the associations between 12 high-risk medications (diabetic agents, diuretics, nonsteroidal anti-inflammatory drugs (NSAIDs), anticoagulants, antiplatelets, antihypertensives, antiarrhythmics, anticonvulsants, antipsychotics, antidepressants, benzodiazepine (BZD)/Z-hypnotics, and narcotics) and unplanned hospitalizations. METHODS: A population-based case–time–control study was performed using the 2000 -2011 Taiwan’s National Health Insurance Research Database. Patients who experienced an unplanned hospitalization (index visit) were identified as index subjects and matched to a randomly selected reference visit within users of a specific category of high-risk medication. Discordant exposures to the high-risk medication during the case period (1-14 days before the visit) and the control period (366-379 days before the visit) were examined in both index and reference visits. For each high-risk medication category, conditional logistic regression models were used to estimate the odds ratios (ORs) of unplanned hospitalizations, and attributable fractions (AFs) for unplanned hospitalizations were calculated. RESULTS: Antipsychotics was associated with the highest risk of unplanned hospitalizations (aOR: 1.54, 95% confidence interval [1.37-1.73], AF: 35.0%), followed by NSAIDs (1.50, [1.44-1.56], 33.3%), anticonvulsants (1.34, [1.10-1.64], 25.6%), diuretics (1.24, [1.15-1.33], 19.1%), BZD/Z-hypnotics (1.23, [1.16-1.31], 18.8%), antidepressants (1.17, [1.05-1.31], 14.7%) and antiplatelets (1.16, [1.07-1.26], 14.0%). NSAIDs and narcotics were associated with the highest risks of unplanned hospitalizations with a length of stay ≥10 days. CONCLUSIONS: Antipsychotics, NSAIDs, anticonvulsants, diuretics, BZD/Z-hypnotics, antidepressants, and antiplatelets were significantly associated with increased risks of unplanned hospitalizations. These drugs should be targeted for clinical and policy interventions.
Conference/Value in Health Info
2016-09, ISPOR Asia Pacific 2016, Singapore
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PHP46
Topic
Epidemiology & Public Health
Topic Subcategory
Safety & Pharmacoepidemiology
Disease
Multiple Diseases