Central Nervous System-Active Medications and Risk of Hospital Readmission in Older Multimorbid Adults.

DOI
Publisher DOI
PubMed ID
40879205
Abstract
Background
Polypharmacy is associated with adverse outcomes, particularly in older multimorbid adults. However, little is known about the negative outcomes associated with multiple central nervous system (CNS)-active medications that are commonly prescribed to these patients.Objective
To assess the association between the number of CNS-active medications at discharge and the risk of 1-year all-cause hospital readmission, drug-related hospital readmission (DRA), death, quality of life (QoL) and functional status in older multimorbid adults.Methods
Among 2008 older multimorbid inpatients with polypharmacy, we assessed the association between the number of CNS-active medications and 1-year all-cause hospital readmission, DRA, and death by Cox proportional hazard models. We further assessed the association of the number of CNS-active medications with QoL (measured with EQ-5D-VAS) and functional status (measured with Barthel Index) using binary and quantile regression models. Analyses were adjusted for age, sex, discharge location, Charlson Comorbidity Index, depression/anxiety, and randomization arm. Additional sensitivity analyses were adjusted for the number of non-CNS active medications, neurological and psychiatric comorbidities, alcohol or tobacco use, education level, and living arrangements.Results
The risk of all-cause hospital readmission and DRA increased by 7% with each additional CNS-active medication (multivariable-adjusted hazard ratio (HR) 1.07 (95% confidence interval 1.03 to 1.12) for all-cause hospital readmission and 1.07 (1.01 to 1.14) for DRA). HR for death was 1.14 (1.07 to 1.23) for each additional CNS-active medication. The mean differences in EQ-5D-VAS and Barthel Index after 1 year were -2.13 (-2.82 to -1.44) and -1.6 (-2.16 to -1.04) respectively, per additional CNS-active medication.Conclusion
The presence of CNS-active medications at discharge is associated with a higher risk for 1-year all-cause hospital readmission and DRA in older multimorbid adults with polypharmacy. Additionally, CNS-active medications were associated with lower QoL and functional status.Trail Registration
ClinicalTrials.gov NCT02986425.
Date Issued
2025-10
Publication Type
Article
Subject(s)
Subjects
hospital readmission
•
multimorbid
•
polypharmacy
•
psychotropic medications
Language(s)
en
Author(s)
Spinewine, Anne
O'Mahony, Denis
Jennings, Emma
Dalleur, Olivia
Knol, Wilma
Koek, Huiberdina L
Additional Credits
Journal
Journal of the American Geriatrics Society
Publisher
Wiley
ISSN
1532-5415
0002-8614
Funding(s)
Access(Rights)
open.access
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