Risk factors pinpointed for diabetes re-admissions

Almost one-quarter of older patients hospitalised for diabetes are back in hospital just 30 days after discharge, a new study claims.

The restrospective study from South Australia found patients with comorbid heart failure had the biggest risk of re-admission followed by patients with more than two hospitalisations in the six months before their diabetes admission.

And, in a research first, patients with multiple prescribers involved in their care were also pinpointed as a risk factor for admission.

Speaking to the limbic Dr Gillian Caughey, senior research fellow of The Quality Use of Medicines and Pharmacy Research Centre at the University of South Australia and lead author on the paper said almost 80% of these hospitalisations occurred within as few as 14 days and almost half of those people had not seen their GP between hospital stays.

“This is a time of increased vulnerability for these patients and we need to make sure they are targeted for continuity of care services after discharge, particularly during the first 14 days.”

While diabetes-related conditions including diabetes-related foot ulcer and hyperglycaemia or hypoglycaemia accounted for 24 per cent of readmissions, cardiovascular conditions accounted for 21 per cent, Dr Caughey said.

“These are older patients some of who have six more comorbid conditions – some of these patients could be on as many as 15 different medications. We need to start thinking, if we aggressively treat their diabetes in hospital, will that affect their heart failure or other comorbid conditions?

“Getting patients to see their GP or specialist in the first few days after discharge so that they can talk to patients about what exactly happened in hospital especially if their medication changed, is key to improving care and reducing the burden of readmission for these patients.

Dr Caughey also noted that medicines reviews had not been undertaken for most of the patients observed in the study.

“If we can identify these patients who are most at risk and then communicate to them and their carers at discharge that this is a timely opportunity to see their GP or specialist, and that a medication review by their pharmacist might be warranted then that could potentially help to reduce the burden of readmission for these patients.”

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