Health in Men Study: is Frailty a predictor of medication related hospitalization?

Abstract

Abstract Background Older adults are at high risk of medication related hospitalizations. Frailty is a phenotype commonly observed in older people due to declining physiological functions. Objective To examine the association of frailty with medication related hospitalization among community dwelling older men. Methods A prospective observational cohort study was conducted among Community –dwelling older men (mean age 75.6 years SD 5.9) from Western Australia (4324) who participated in the Health in Men study. Participants were followed-up at 12 and 24 months to determine adverse drug event related hospitalization, hospitalizations for other causes and mortality. Results The prevalence of frailty was 13.2%. At baseline, frailty was associated with exposure to polypharmacy, potentially inappropriate medication use and potential adverse drug-drug interactions with unadjusted odds ratios; 4.13 (3.48 – 4.89) P < 0.001], 2.46 (1.91-3.17) P<.001], 3.85 (3.03-4.90) P < 0.001] respectively. In unadjusted models, frail men were more likely to have non-accidental falls [OR 3.16 (2.51-3.99) P<.001], acute kidney injury [OR 3.37 (2.35-4.82) P<.001], ADE related hospitalizations at 12 months [OR 6.83 (4.91-9.51)], and non-ADE related hospitalisations [OR 2.63 (2.01 -3.45)], or to be dead at 12 months [OR 2.97 (1.79-4.92)] and at 24 months [OR 3.14 (2.28-4.33)] when compared with non-frail men. After adjusting for age, living alone, cognitive decline, smoking status and co-morbidity frailty remained associated with ADE related hospitalization [OR 3.60(2.41-5.37)], non-ADE related hospitalizations [OR 1.74 (1.29-2.36)] and death [OR 1.67 (1.15-2.41)]. Conclusion The study suggests that frailty is a predictor of medication related harm with poorer clinical outcomes including mortality.