In most health systems there are programs to track whether highly effective interventions are being used appropriately. When they aren’t being properly used, efforts are made to improve their use. The eleven medications we identified should be part of these programs.
- Nik Bobrovitz, University of Oxford
The most effective medicines for preventing emergency hospital admissions have been identified by a team of researchers in Oxford University's Nuffield Department of Primary Care Health Sciences. Reporting in BMC Medicine, the authors suggest these treatments could be considered for inclusion in quality monitoring and improvement strategies.
The researchers reviewed data from nearly 2,000 drug trials and 1 million patients. They identified eleven commonly used medications that significantly reduce emergency admission rates in patients with major chronic diseases, such as heart failure, asthma, and chronic obstructive pulmonary disease.
The study's lead author, DPhil Student Nik Bobrovitz, says this is a key step towards reducing emergency care pressures.
“We need to reduce demand on emergency services, which are currently stretched to their limit. Past initiatives have failed. We decided to examine the issue from a unique and simple perspective.
"In patients with chronic diseases, medications can help to manage symptoms and prevent flare-ups that would otherwise require urgent health care. These medications we highlighted are highly effective at helping people better deal with their disease and stay out of the hospital.”
The UK-based researchers suggest their study has implications for health systems all over the world.
“In most health systems there are programs to track whether highly effective interventions are being used appropriately. When they aren’t being properly used, efforts are made to improve their use. The eleven medications we identified should be part of these programs. We know from previous studies that these drugs are not always prescribed to patients that need them and, often, are prescribed in too low a dose.”
The researchers hope their work will help to ease the burden on emergency services.
“We believe our research will help to improve patient care. It will also make important progress in better managing emergency hospital admissions. This is a simple strategy that has been overlooked. We believe it can be an effective solution to a complex problem.”
This research was funded by the National Institute for Health Research School for Primary Care Research. The views expressed are those of the authors and not necessarily those of the NIHR, the NHS or the Department for Health and Social Care.
Medications that reduce emergency hospital admissions: an overview of systematic reviews and prioritisation treatments.
Niklas Bobrotiz, Carl Heneghan, Igho Onakpoya, Benjamin Fletcher, Dylan Collins, Alice Tompson, Joseph Lee, David Nunan, Rebecca Fisher, Brittney Scott, Jack O'Sullivan, Oliver Van Hecke, Brian D Nicholson, Sarah Stevens, Nia Roberts and Kamal R Mahtani.
BMC Medicine. 2018 https://doi.org/10.1186/s12916-018-1104-9