title: Association between number of doses per day, number of medications and patient's non-compliance, and frequency of readmissions in a multi-ethnic Asian population.
abstract: OBJECTIVE
  To investigate whether number of doses per day and number of medications are significantly associated with the number of readmissions and to study the association of readmission frequency with other medical and socio-demographic variables.
  
  
  METHODS
  Retrospective cross-sectional study involving 432 patients who were readmitted within 15 days of previous hospital discharge between January 1, 2013 and March 31, 2013. Relevant medical records were collected from the national electronic databases of every public tertiary hospital in Singapore. Significant variables (p < 0.05) were identified using forward selection and modeled using generalized linear mixed models.
  
  
  RESULTS
  A total of 649 unplanned readmissions were reviewed. At a multivariable level, number of readmission was significantly associated with the number of medications (p = 0.002) and number of doses per day (p = 0.003) after adjusting for race, liver disease, schizophrenia and non-compliance.
  
  
  CONCLUSIONS
  Complex medication regimen (i.e. multiple medications and multiple doses per day) is a statistically significant predictor of number of readmissions. Simplifying therapeutic regimens with alternatives such as longer-acting or fixed-dose combination drugs may facilitate better patient adherence and reduce costly readmissions.
authors: Department of Pharmacy, Faculty of Science, National University of Singapore, Republic of Singapore.
authors: Ming Ren
authors: MR
authors: Toh
authors: Department of Pharmacy, Faculty of Science, National University of Singapore, Republic of Singapore.
authors: Vivien
authors: V
authors: Teo
authors: Department of Pharmacy, Faculty of Science, National University of Singapore, Republic of Singapore; Centre of Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Graduate Medical School, Republic of Singapore.
authors: Yu Heng
authors: YH
authors: Kwan
authors: Department of Pharmacy, Faculty of Science, National University of Singapore, Republic of Singapore.
authors: Sreemanee
authors: S
authors: Raaj
authors: Department of Pharmacy, Khoo Teck Puat Hospital, Republic of Singapore.
authors: Su-Yin Doreen
authors: SY
authors: Tan
authors: Department of Pharmacy, Khoo Teck Puat Hospital, Republic of Singapore.
authors: Joyce Zhen Yin
authors: JZ
authors: Tan
keywords: Non-compliance; Number of doses per day; Polypharmacy; Readmissions; Rehospitalizations