Drug-Related Admissions Affect More Than One in Three Chronic Care Patients
In a chronic internal medicine setting at Wolaita Sodo University Comprehensive Specialized Hospital, drug-related hospital admissions emerged as a frequent and clinically consequential burden. Among 367 patients, 34.6% were admitted because of medication-related problems, a proportion that should immediately command attention in any ward managing long-term disease. The figure is high enough to suggest more than isolated prescribing mishaps; it points to a system in which complex pharmacotherapy, chronic illness, and gaps in medication use are colliding at the bedside.
The study used an institutional cross-sectional design and a previously validated tool to identify admissions tied to drug-related problems. Binary logistic regression and multivariable modeling were used to isolate factors associated with these admissions, with statistical significance set at a p-value below 0.05. Those methods matter because they move the analysis beyond raw frequency and toward the clinical profile of patients most likely to be harmed by medication-related failure. In practical terms, the data map a group that internal medicine teams should watch more closely: patients with multiple comorbidities, kidney disease, younger adults, and urban residence.
The strongest signal came from multimorbidity. Patients with three or more comorbidities had more than three times the odds of a drug-related admission compared with those without that burden, with an adjusted odds ratio of 3.25. Even patients with one to two comorbidities faced nearly doubled risk, with an adjusted odds ratio of 1.98. Polymorbidity expands prescription lists, increases the chance of drug interactions, and forces clinicians to balance competing treatment targets. In a chronic care ward, every additional diagnosis can widen the space for under-treatment, over-treatment, duplication, and adherence failure.
Kidney disease carried its own risk. Chronic kidney disease was associated with a 2.41-fold increase in odds of admission, a clinically coherent finding because renal impairment changes drug clearance, narrows therapeutic windows, and magnifies the consequences of dosing errors. Many common medications require adjustment when kidney function declines; when that does not happen, toxicity can develop silently before it becomes severe enough to require hospitalization. CKD also tends to coexist with hypertension, diabetes, and cardiovascular disease, which further increases the complexity of medication regimens and the risk of preventable harm.
Preventable Medication Failures Drove Much of the Burden
The admissions were not dominated by obscure or unavoidable events. Noncompliance, untreated indications, unnecessary drugs, and adverse drug reactions were the most common causes, and most were preventable. That mix is important because it places responsibility not only on the pharmacology of the medicines themselves, but also on how treatment is prescribed, explained, dispensed, and followed over time.
Noncompliance often reflects more than patient choice alone. In chronic disease management, missed doses may arise from pill burden, cost, limited understanding of the regimen, adverse effects, or inconsistent follow-up. Untreated indications point in the opposite direction: a missed opportunity to start a medicine when one is clinically needed. Unnecessary drug use creates another hazard, especially when duplicate therapies or low-value prescriptions accumulate across multiple visits. Adverse drug reactions then close the loop, converting a prescribing decision into an admission.
Younger adults aged 18 to 35 years also had higher odds of drug-related hospitalization, with an adjusted odds ratio of 1.65. Urban residence was associated with a 54% increase in odds, with an adjusted odds ratio of 1.54. Those findings invite a careful bedside reading rather than a simplistic one. Younger adults may carry chronic disease with less stable follow-up, lower perceived vulnerability, or less consistent adherence than older patients who have lived longer with treatment routines. Urban residence may reflect greater access to care, higher medication exposure, or more frequent diagnosis of drug-related problems, rather than lower risk in the community itself.
The study setting matters because it is a chronic internal medicine ward, where the clinical mix typically includes long-term pharmacotherapy, evolving organ dysfunction, and repeated medication changes. In that environment, drug-related admissions are not random events. They are often the endpoint of a process that begins with a prescription, continues through dispensing and counseling, and ends when the patient decompensates enough to require inpatient care. Once that chain is visible, prevention becomes easier to imagine: medication review, renal dose adjustment, adherence support, and explicit reconciliation of all active drugs at every encounter.
The authors’ conclusion that drug-related hospital admissions were considerably high fits the observed data, but the more actionable point is the nature of the admissions themselves. The most common causes were largely preventable. A ward that identifies comorbidity burden and CKD early can use those variables as practical risk markers for intensified medication monitoring. Pharmacy involvement, regimen simplification, and regular review for unnecessary drugs are not abstract quality goals here; they are the direct countermeasures suggested by the admission pattern.
A hospital that treats chronic disease without systematic medication surveillance will keep seeing the same result: avoidable admissions, repeated exposure to drug harm, and a heavier load on already stretched internal medicine services. This study identifies the patients most likely to fall through those cracks and shows where prevention has the greatest chance of working before admission becomes inevitable.