Ambulatory drug changes in the elderly after hospital discharge: A cohort study

Therapie. 2021 Nov-Dec;76(6):587-595. doi: 10.1016/j.therap.2021.04.015. Epub 2021 May 5.


Aim: To describe the ambulatory changes in drug prescriptions 3 months after hospital discharge among elderly patients aged 75 and over, and to identify the reasons for these changes.

Methods: A prospective cohort study was conducted on subjects, discharged between 09/2016 and 01/2017 from the Bordeaux University Hospital. Prescription forms were collected from patients' pharmacists. The main outcome was the occurrence of at least one significant change (SC) defined as an initiation, a discontinuation, a switch or change in drug daily dosage as regards the drugs prescribed upon hospital discharge and those prescribed 3 months after. Whenever drug SC occurred, general practitioners were requested to elicit reasons for such changes.

Results: Among the 126 patients included in our study, 73 underwent a 3-month follow-up period, without death or being re-hospitalised. 87.7% of them had at least one SC 3 months after discharge, with an average of 3.1±2.5 SC per patient. Main changes involved: discontinuation or dose decrease of anxiolytics, hypnotics, antalgics, betablockers and calcium channel blockers; start or dose increase of diuretics, ACE inhibitors and angiotensin receptor blockers. In patients with a 3-month follow-up period, 27.4% underwent at least one ADR-induced SC.

Conclusion: Most elderly patients experience drug prescription changes after discharge. Some, according to drug iatrogenic, could be avoided through better cooperation between hospital and ambulatory prescribers.

Keywords: Cohort studies; Continuity of patient care; Drug prescriptions; Elderly; General practice; Patient discharge.

MeSH terms

  • Aged
  • Cohort Studies
  • Drug Prescriptions
  • Hospitals, University
  • Humans
  • Patient Discharge*
  • Pharmaceutical Preparations*
  • Prospective Studies


  • Pharmaceutical Preparations