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Managing blood pressure medication at discharge

BMJ 2018; 362 doi: (Published 12 September 2018) Cite this as: BMJ 2018;362:k3789
  1. Nathan M Stall, geriatrician and research fellow1,
  2. Chaim M Bell, professor of medicine and health policy management & evaluation, and physician-in-chief2
  1. 1Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
  2. 2Division of General Internal Medicine, Sinai Health System, Toronto, ON, Canada M5G 1X5
  1. Correspondence to: C M Bell chaim.bell{at}

What happens in hospital stays in hospital

Discharge from hospital is an especially high risk transition for older adults. Despite recovery from the condition for which they were admitted, many patients are discharged with a functional status that is substantially worse than their pre-admission baseline.1 Recently, increasing attention has been paid to this problem, including the generalized period of risk immediately after discharge now known as post-hospital syndrome.2 One major contributor to post-hospital syndrome is medication related harm from drugs newly started or intensified during hospital admission.

In the BMJ this week (doi:10.1136/bmj.k3503), Anderson and colleagues report a retrospective cohort analysis of older adults admitted to hospital, conducted using national inpatient and outpatient Veterans Affairs pharmacy data merged with Veterans Affairs and Medicare claims data.3 The study investigated the frequency of intensification of antihypertensive treatment at hospital discharge (a new or higher dose antihypertensive at discharge compared with treatment before admission). The …

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