Patients’ and providers’ perspectives on medication relatedness and potential preventability of hospital readmissions within 30 days of discharge

• Published in: Health expectations : an international journal of public participation in health care and health policy Vol. 23; no. 1; pp. 212 - 219
• Main Authors: Uitvlugt, Elien B., Janssen, Marjo J. A., Siegert, Carl E. H., Leenders, Anna J. A., Bemt, Bart J. F., Bemt, Patricia M. L. A., Karapinar‐Çarkit, Fatma
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01-02-2020; John Wiley and Sons Inc; Wiley
• Subjects: Cardiology; Caregivers; Cross-Sectional Studies; Data analysis; Discharge; Drug therapy; Drugs; Family physicians; Female; Health care; Health risks; hospital readmissions; Hospitalization; Hospitals; Humans; Inpatients - statistics & numerical data; Internal medicine; Intervention; Interviews; Male; Medical personnel; Medical research; medication; Middle Aged; Netherlands; Original Research Paper; Original Research Papers; Patient admissions; Patient Discharge; Patient Readmission - statistics & numerical data; Patients; patients’ perspectives; Pharmaceuticals; Polypharmacy; Prescription drugs; preventability; Primary care; providers’ perspective; Readmission; Relatedness; Risk analysis; Risk Factors; Time Factors; Netherlands; medication; hospital readmissions; patients’ perspectives; providers’ perspective; preventability
• DOI: 10.1111/hex.12993
• EISSN: 1369-7625
• ISSN: 1369-6513

Background
Hospital readmissions are increasingly used as an indicator of quality in health care. One potential risk factor of readmissions is polypharmacy. No studies have explored the patients’ perspectives on the medication relatedness and potential preventability of their readmissions.
Objective
To compare the patients’ perspectives on the medication relatedness and potential preventability of their readmissions with the providers’ perspectives.
Methods
Patients unplanned readmitted within 30 days after discharge at one of the participating departments of OLVG Hospital in Amsterdam were interviewed during their readmission. Patients’ perspectives regarding medication relatedness of their readmissions, the potential preventability, possible preventable interventions, and satisfaction with medication information were examined. Health‐care providers also reviewed files of these readmitted patients. Primary outcome was the percentage of medication‐related and potentially preventable readmissions according to the patient vs the provider. Descriptive data analysis was used.
Results
According to patients, 36 of 172 (21%) readmissions were medication‐related, and of these, 21 (58%) were potentially preventable. According to providers, 26 (15%) readmissions were medication‐related and 6 (23%) of these were potentially preventable. Patients and providers agreed on the medication relatedness in 11 of the 172 readmissions, and in two of these, agreement on the potential preventability existed. According to patients, preventive interventions belonged mostly to the hospital level, followed by the primary care level and patient level.
Conclusion
Patients and providers differ substantially on their perspectives regarding the medication relatedness and preventability of readmissions. Patients were more likely to view medication‐related readmissions as preventable.