Medication-related hospitalisations in patients with SLE
Objectives Patients with SLE take multiple medications. Within a large prospective longitudinal SLE cohort, we characterised medication-related hospitalisations and their preventability.Methods We identified consecutive admissions to our tertiary hospitals between 2015 and 2020. Two independent adju...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2025-01-01
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| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/12/1/e001362.full |
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| author | Arielle Mendel Évelyne Vinet Sasha Bernatsky Christian A Pineau Fares Kalache Louis-Pierre Grenier Emily G McDonald Michèle Stanciu Joo-Young Esther Lee Gregory Clark |
| author_facet | Arielle Mendel Évelyne Vinet Sasha Bernatsky Christian A Pineau Fares Kalache Louis-Pierre Grenier Emily G McDonald Michèle Stanciu Joo-Young Esther Lee Gregory Clark |
| author_sort | Arielle Mendel |
| collection | DOAJ |
| description | Objectives Patients with SLE take multiple medications. Within a large prospective longitudinal SLE cohort, we characterised medication-related hospitalisations and their preventability.Methods We identified consecutive admissions to our tertiary hospitals between 2015 and 2020. Two independent adjudicators evaluated if medication-related events contributed to the hospitalisation, considering (1) adverse drug events (ADEs) and (2) events from medication non-adherence, using the Leape and Bates method. We classified ADEs as potentially preventable/ameliorable if we identified modifiable factors. Logistic regressions with generalised estimating equations evaluated associations between participant characteristics and medication-related hospitalisations, accounting for repeat hospitalisations within the same participant.Results We studied 68 hospitalisations among 45 participants (91% female). At first hospitalisation, the median age was 38 years (IQR 26.5–53.0) and median SLE duration was 12 years (IQR 5.5–19.5). One or more ADEs contributed to 20 (29%) hospitalisations (11/23 (48%) ADEs being preventable/ameliorable), and SLE flares associated with medication non-adherence contributed to 7 (10%) hospitalisations. Adjusting for age and sex, current prednisone use (adjusted OR (aOR) 3.7, 95% CI 1.1 to 13.0) or ≥1 current immunosuppressant (aOR 11.5, 95% CI 2.7 to 50.0), renal involvement at SLE diagnosis (aOR 6.5, 95% CI 2.7 to 15.7) and polypharmacy (≥5 medications; aOR 11.3, 95% CI 1.2 to 103.8) were associated with having an ADE-related (vs non-ADE) hospitalisation. Age at SLE diagnosis<18 years (OR 5.9, 95% CI 1.3 to 26.6) was associated with hospitalisation for a flare related to non-adherence.Conclusion Forty per cent of SLE hospitalisations were medication-related, while half were potentially preventable/ameliorable. Renal involvement, polypharmacy, prednisone and immunosuppressant use were associated with hospitalisation related to an ADE, highlighting a vulnerable group. |
| format | Article |
| id | doaj-art-3534856e7c1c412e978ba6f9200209dd |
| institution | Kabale University |
| issn | 2053-8790 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Lupus Science and Medicine |
| spelling | doaj-art-3534856e7c1c412e978ba6f9200209dd2025-01-31T22:20:09ZengBMJ Publishing GroupLupus Science and Medicine2053-87902025-01-0112110.1136/lupus-2024-001362Medication-related hospitalisations in patients with SLEArielle Mendel0Évelyne Vinet1Sasha Bernatsky2Christian A Pineau3Fares Kalache4Louis-Pierre Grenier5Emily G McDonald6Michèle Stanciu7Joo-Young Esther Lee8Gregory Clark9Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, Quebec, CanadaCentre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, Quebec, CanadaCentre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, Quebec, CanadaDivision of Rheumatology, McGill University Health Centre, Montreal, Quebec, CanadaDivision of Rheumatology, McGill University Health Centre, Montreal, Quebec, CanadaDivision of Rheumatology, McGill University Health Centre, Montreal, Quebec, CanadaCentre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, Quebec, CanadaMcGill University, Montreal, Quebec, CanadaCentre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, Quebec, CanadaDepartment of Emergency Medicine, McGill University Health Centre, Montreal, Quebec, CanadaObjectives Patients with SLE take multiple medications. Within a large prospective longitudinal SLE cohort, we characterised medication-related hospitalisations and their preventability.Methods We identified consecutive admissions to our tertiary hospitals between 2015 and 2020. Two independent adjudicators evaluated if medication-related events contributed to the hospitalisation, considering (1) adverse drug events (ADEs) and (2) events from medication non-adherence, using the Leape and Bates method. We classified ADEs as potentially preventable/ameliorable if we identified modifiable factors. Logistic regressions with generalised estimating equations evaluated associations between participant characteristics and medication-related hospitalisations, accounting for repeat hospitalisations within the same participant.Results We studied 68 hospitalisations among 45 participants (91% female). At first hospitalisation, the median age was 38 years (IQR 26.5–53.0) and median SLE duration was 12 years (IQR 5.5–19.5). One or more ADEs contributed to 20 (29%) hospitalisations (11/23 (48%) ADEs being preventable/ameliorable), and SLE flares associated with medication non-adherence contributed to 7 (10%) hospitalisations. Adjusting for age and sex, current prednisone use (adjusted OR (aOR) 3.7, 95% CI 1.1 to 13.0) or ≥1 current immunosuppressant (aOR 11.5, 95% CI 2.7 to 50.0), renal involvement at SLE diagnosis (aOR 6.5, 95% CI 2.7 to 15.7) and polypharmacy (≥5 medications; aOR 11.3, 95% CI 1.2 to 103.8) were associated with having an ADE-related (vs non-ADE) hospitalisation. Age at SLE diagnosis<18 years (OR 5.9, 95% CI 1.3 to 26.6) was associated with hospitalisation for a flare related to non-adherence.Conclusion Forty per cent of SLE hospitalisations were medication-related, while half were potentially preventable/ameliorable. Renal involvement, polypharmacy, prednisone and immunosuppressant use were associated with hospitalisation related to an ADE, highlighting a vulnerable group.https://lupus.bmj.com/content/12/1/e001362.full |
| spellingShingle | Arielle Mendel Évelyne Vinet Sasha Bernatsky Christian A Pineau Fares Kalache Louis-Pierre Grenier Emily G McDonald Michèle Stanciu Joo-Young Esther Lee Gregory Clark Medication-related hospitalisations in patients with SLE Lupus Science and Medicine |
| title | Medication-related hospitalisations in patients with SLE |
| title_full | Medication-related hospitalisations in patients with SLE |
| title_fullStr | Medication-related hospitalisations in patients with SLE |
| title_full_unstemmed | Medication-related hospitalisations in patients with SLE |
| title_short | Medication-related hospitalisations in patients with SLE |
| title_sort | medication related hospitalisations in patients with sle |
| url | https://lupus.bmj.com/content/12/1/e001362.full |
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