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Hospital Admissions due to Medication-Related Harm in the Last 5 Years of Life: A Cohort Study

Judy R Mullan1, Stephen Moules2, Andrew Bonney1

  • 1Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.

Australasian Journal on Ageing
|October 23, 2025
PubMed
Abstract

Insights

Medication-related harm (MRH) led to hospital admissions for up to 40% of decedents in their final years. Younger age, metropolitan residence, and chronic conditions increased MRH admission risk.

Area of Science:

  • Gerontology
  • Public Health
  • Pharmacovigilance

Background:

  • The World Health Organization's "Medication without Harm" initiative targets preventable medication-related harm (MRH).
  • MRH is a significant contributor to preventable harm, necessitating ongoing research and interventions.
  • This study focuses on identifying factors associated with MRH hospital admissions in elderly decedents.

Purpose of the Study:

  • To investigate demographic and clinical factors linked to hospital admissions due to medication-related harm (MRH).
  • To analyze MRH hospital admission rates among decedents in their final five years of life.
  • To inform targeted interventions for high-risk patient populations.

Main Methods:

  • Retrospective cohort study utilizing linked, non-identifiable data from an Australian Local Health District (LHD).
  • Inclusion criteria: residents aged 65 years and over who died in LHD hospitals between 2017 and 2019.
  • Logistic regression models were employed to determine odds ratios for MRH hospital admissions.

Main Results:

  • 31%-40% of 4353 decedents experienced at least one MRH hospital admission in their last 5 years of life, comprising 5% of total admissions.
  • Higher MRH admission rates were found in individuals under 70 years, metropolitan residents, and those in residential aged care facilities.
  • Significant predictors of MRH admissions included comorbidities like renal failure, heart failure, diabetes, and COPD.

Conclusions:

  • Approximately one-third of decedents in the cohort were hospitalized due to MRH in their final five years.
  • Risk factors for MRH hospitalizations included younger age (<70), living in metropolitan or aged care settings, and multiple/specific chronic conditions.
  • Findings underscore the necessity for targeted interventions for high-risk individuals approaching end-of-life to mitigate medication-related harm.
Keywords:
agedcomorbidityfrailtyhospitalisationmedication errorspolypharmacy

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