Prescribing Benzodiazepines and Opioids and Clinical Characteristics Associated With 30-Day Hospital Return in Patients Aged ≥75 Years: Secondary Data Analysis

IF 1.1 4区 医学 Q4 GERIATRICS & GERONTOLOGY Journal of gerontological nursing Pub Date : 2024-04-01 DOI:10.3928/00989134-20240312-02
Juyoung Park, PhD, MSW, Gabriella Engstrom, PhD, RN, Joseph G. Ouslander, MD
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Abstract

Purpose:

The current study compared prevalence of opioid or benzodiazepine (BZD) prescription and co-prescription of opioids and BZD at discharge and return to a community hospital within 30 days, as well as identified clinical characteristics associated with hospital return in patients aged ≥75 years.

Method:

A secondary analysis of a database created during implementation of the Safe Transitions for At Risk Patients program at a 400-bed community teaching hospital in south Florida was conducted. Multivariable logistic regression analyses were performed to identify significant demographic and clinical characteristics associated with return to the hospital within 30 days of discharge.

Results:

A total of 24,262 participants (52.6% women) with a mean age of 85.3 (SD = 6.42) years were included. More than 20% in each central nervous system prescription group (i.e., opioids only, BZD only, opioids and BZD) returned to the hospital within 30 days of discharge. Demographic and chronic conditions (e.g., congestive heart failure, chronic obstructive pulmonary disease, diabetes) and poly-pharmacy were significant factors of a 30-day return to the hospital.

Conclusion:

Findings highlight the importance of hospital nurses' role in identifying high-risk patients, educating patients and caregivers, monitoring them closely, communicating with primary care physicians and specialists, and conducting intensive follow up via telephone to avoid 30-day rehospitalization. [Journal of Gerontological Nursing, 50(4), 25–33.]

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年龄≥75 岁患者的苯二氮卓类药物和阿片类药物处方以及与 30 天住院返院相关的临床特征:二次数据分析
目的:本研究比较了出院时阿片类药物或苯二氮卓类药物(BZD)处方的流行率以及阿片类药物和苯二氮卓类药物的联合处方,并确定了年龄≥75岁的患者在出院后30天内重返社区医院的相关临床特征。方法:本研究对佛罗里达州南部一家拥有400张床位的社区教学医院在实施 "高危患者安全过渡 "计划期间创建的数据库进行了二次分析。结果:共纳入了 24262 名参与者(52.6% 为女性),他们的平均年龄为 85.3 岁(SD = 6.42)。每个中枢神经系统处方组(即仅阿片类药物组、仅BZD组、阿片类药物和BZD组)均有20%以上的患者在出院后30天内重返医院。结论:研究结果凸显了医院护士在识别高风险患者、教育患者和护理人员、密切监测患者、与主治医生和专科医生沟通以及通过电话进行强化随访以避免患者30天内再次住院方面所扮演的重要角色。[老年护理杂志》,50(4),25-33。]
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来源期刊
CiteScore
2.00
自引率
7.70%
发文量
98
审稿时长
6-12 weeks
期刊介绍: The Journal of Gerontological Nursing is a monthly, peer-reviewed journal publishing clinically relevant original articles on the practice of gerontological nursing across the continuum of care in a variety of health care settings, for more than 40 years.
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