Prevalence of high-risk medications in patients enrolled in the Hospital Elder Life Program
Macias Tejada JA, Klumph M, Heslin K, Khan A, Malone ML. Prevalence of high-risk medications in patients enrolled in the Hospital Elder Life Program. J Am Geriatr Soc. Published online March 26, 2021. doi: 10.1111/jgs.17133. Online ahead of print.
OBJECTIVE: The study aimed to assess the prevalence of newly prescribed antipsychotic/benzodiazepine medication, as well as 30-day readmissions, among Hospital Elder Life Program (HELP)-enrolled patients.
DESIGN: Retrospective case-control study.
SETTING: HELP intervention took place in eight hospital units. The standard care group was selected from eight additional hospital units.
PARTICIPANTS: Hospitalized patients, aged 65 years and older, enrolled in HELP during between January 1, 2017 to December 31, 2018 were included in the HELP cohort. Patients hospitalized in eight additional units during the same time frame were part of the standard care group.
MEASUREMENTS: Antipsychotic/benzodiazepine medications were pulled from the electronic health record. History of chronic mental illnesses were classified by ICD10 codes. Basic descriptive statistics were used to analyze patient characteristics and comorbidities. Chi-squared and t-tests were performed to detect statistical differences as appropriate.
RESULTS: There were 1411 patients in the HELP group and 10,807 patients in the standard care group. The HELP group was likely to be older, female and to have a shorten length of stay (all p ≤ 0.02). Our study demonstrated that approximately 8.9% (n = 125) of patients enrolled in HELP received an order for antipsychotics during their hospital admission, while 31.5% (n = 3400) from the standard care group (p < 0.001). The difference in benzodiazepine prescription in patients enrolled in HELP was also less when comparing the two groups (22.8% HELP vs 25.6% standard care; p = 0.02).
CONCLUSIONS: Patients enrolled in the HELP group were less likely to receive a prescription for antipsychotics or benzodiazepines. The majority of patients enrolled in HELP were discharged to a more independent environment (home or assisted living) and there was a relatively low 30-day readmission rate among HELP patients.