Background: The aim of this study was to assess the association between prescription changes frequency (PCF)\r\nand hospital admissions and to compare the PCF to the Chronic Disease Score (CDS). The CDS measures\r\ncomorbidity on the basis of the 1-year pharmacy dispensing data. In contrast, the PCF is based on prescription\r\nchanges over a 3-month period.\r\nMethods: A retrospective matched caseââ?¬â??control design was conducted. 10.000 patients were selected randomly from\r\nthe Dutch PHARMO database, who had been hospitalized (index date) between July 1, 1998 and June 30, 2000. The\r\nprimary study outcome was the number of prescription changes during several three-month time periods starting 18,\r\n12, 9, 6, and 3 months before the index date. For each hospitalized patient, one nonhospitalized patient was matched\r\nfor age, sex, and geographic area, and was assigned the same index date as the corresponding hospitalized patient.\r\nWe classified four mutually exclusive types of prescription changes: change in dosage, switch, stop and start.\r\nResults: The study population comprised 8,681 hospitalized patients and an equal number of matched nonhospitalized\r\npatients. The odds ratio of hospital admission increased with an increase in PCF category. At 3 months before the index\r\ndate from PCF=1 OR 1.4 [95% CI 1.3-1.5] to PCF= 2ââ?¬â??3 OR 2.2 [95% CI 1.9-2.4] and to PCF = 4 OR 4.1 [95% CI 3.1-5.1]. A\r\nhigher CDS score was also associated with an increased odds ratio of hospitalization: OR 1.3 (95% CI 1.2-1.4) for CDS\r\n3ââ?¬â??4, and OR 3.0 (95% CI 2.7-3.3) for CDS 5 or higher.\r\nConclusion: The prescription change frequency (PCF) is associated with hospital admission, like the CDS.\r\nPharmacists and other healthcare workers should be alert when the frequency of prescription changes increases.\r\nClinical rules could be helpful to make pharmacists and physicians aware of the risk of the number of prescription\r\nchanges.
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