Both the types of medications and the sheer number can lead to adverse drug events after hospitalization

Adverse drug events are common in the days and weeks after people have been in the hospital, especially among older people. Recent research suggests that 5% to 6% of older patients experience posthospitalization adverse drug events.

Joshua M. Pevnick, an associate professor at Cedars-Sinai Medical Center in Los Angeles, led a study of a pharmacist-led program with the goal of reducing hospitalizations from adverse drug events. The results, published last week in JAMA Network Open, were mixed, with the program not producing statistically significant difference in the overall group of approximately 6,500 patients but having a sizable effect in a subgroup of patients with low medication adherence and literacy.

In an interview with Managed Healthcare Executive (MHE), Pevnick discussed whether certain medications are the adverse drug event culprits or whether it is the sheer number of medications that are responsible. He said that Dan Budnitz, M.D., M.P.H., a researcher at the Centers for Disease Control and Prevention, has published a series of papers that pointed to anticoagulants, antiplatelet, antihyperglycemics and opioids as being primarily responsible for emergency room visits related to adverse drug events among older people. Pevnick said he and his colleagues decided to remove opioid adverse drug events from their study because “it’s kind of a whole separate problem.”

They also included people with 10 or more long-term prescriptions in the study, and, as it turned out, most of the people enrolled were in that group. Pevnick said that managing that number of medications, especially when a hospitalization is involved, is difficult.

“Whether it’s the patient or their care partners who are helping them or the doctors who are trying to keep track of the medication when they’re going in and out of the hospital, it just becomes a huge mess,” Pevnick said.