Oxford, UK—Emergency hospital admissions can be costly events, which is why it is so important to avoid those when possible. With that goal in mind, a new study identifies 11 medications that can be helpful but are inconsistently prescribed.

The report in BMC Medicine notes that although many are routinely prescribed in clinical practice, how often they are used varies significantly.

University of Oxford–led researchers point out that emergency hospitalizations are on the increase in many countries and that pinpointing strategies to reduce them is essential.

The study team decided to focus on medication therapies that potentially drive down use of emergency healthcare services. Their objectives were to:
• Systematically review the evidence to identify medications that affect emergency hospital admissions, and
• Prioritize therapies for quality measurement and improvement.

To perform the meta-analysis, researchers looked at MEDLINE, PubMed, the Cochrane Database of Systematic Reviews & Database of Abstracts of Reviews of Effects, Google Scholar, and the websites of 10 major funding agencies and health charities, using broad search criteria.

Included were systematic reviews of randomized controlled trials (RCTs) that examined the effect of any medication on adult emergency hospital admissions. Ultimately, 140 systematic reviews were identified, involving 1,968 unique RCTs and more than 925,000 patients.

Discussed in the reviews were 100 medications tested in 47 participant groups; the study team focused on 28 medications that reduced admissions, based on high- to moderate-quality evidence. Clinical guidelines in the United States, the United Kingdom, and Europe supported 11 of the 28 drugs, the reviewers determined.

Those include therapies used for patients with:
• Heart failure—angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, aldosterone receptor antagonists, and digoxin
• Stable coronary artery disease—intensive statin therapy
• Asthma exacerbations—early inhaled corticosteroids in the emergency department and anticholinergics
• Chronic obstructive pulmonary disease—long-acting muscarinic antagonists and long-acting beta-2 adrenoceptor agonists, and
• Schizophrenia—second-generation antipsychotics and depot/maintenance antipsychotics

“We identified 11 medications supported by strong evidence and clinical guidelines that could be considered in quality monitoring and improvement strategies to help reduce emergency hospital admission rates,” study authors conclude. “The findings are relevant to health systems with a large burden of chronic disease and those managing increasing pressures on acute healthcare services.”

 « Click here to return to Weekly News Update.