Seniors with chronic disease often leave the hospital without prescriptions for the medicine they were getting when they arrived, Canadian researchers said Tuesday.

In some cases, that may have upped their risk of landing in the emergency room over the following year, or even dying, the team reports in the Journal of the American Medical Association.

"These are people that have been identified to have a disease and have been appropriately treated with evidence-based treatment for that disease," said Dr. Chaim Bell of St. Michael's Hospital in Toronto, who worked on the study. "So these are success stories."

"After hospitalizations they are no longer on these medications, and that's a shame," he told Reuters Health.

Bell and his colleagues used medical records for nearly 400,000 elderly people in Ontario to see how often those people left the hospital without renewed prescriptions for five long-term medications — including the cholesterol-lowering statins, blood thinners and similar drugs, as well as asthma inhalers.

The researchers then compared those who'd been admitted to a hospital with those who hadn't.
For the blood thinners, which include aspirin, as many as 19 percent of the seniors who had been hospitalized failed to get a renewed prescription within three months.

By contrast, that number was less than 12 percent for people who hadn't been admitted to the hospital between 1997 and 2009.

For the other medications, the difference was less pronounced, but still there — especially for those patients who landed in the intensive care unit.

While their study can't prove that hospital stays caused patients to drop their medications, Bell said he had taken measures to ensure that in most cases the discontinuation was unintentional.
The researchers also found that patients who discontinued statins and blood thinners — both of which are often used to treat heart disease — had a slightly higher risk of dying or landing in the emergency room over the next year.

Bell said that many seniors are on multiple drugs and simply may not notice that a prescription hasn't been renewed after they leave the hospital.

"There needs to be better communication" at the hospital, said Bell, adding that it could be hard to get a complete list of the medicine patients are on when they get admitted.

"Everybody is calling for the electronic patient record," he told Reuters Health.

In an editorial in the journal, Dr. Jeremy Kahn and Dr. Derek Angus of the University of Pittsburgh note that landing in the hospital can be a chance to adjust people's drugs and help them change their lifestyle.

"However, transitions of care are also a threat, especially for patients with chronic diseases and complex treatment regimens," they add. "Either because of miscommunication or simple error, patients may experience unwarranted changes in treatment with potentially deleterious effects on their health."