scholarly journals Validation of a Patient‐Level Medication Regimen Complexity Index as a Possible Tool to Identify Patients for Medication Therapy Management Intervention

2014 ◽  
Vol 34 (8) ◽  
pp. 826-835 ◽  
Author(s):  
Jan D. Hirsch ◽  
Kelli R. Metz ◽  
Patrick W Hosokawa ◽  
Anne M. Libby
Keyword(s):  
Medication Therapy Management ◽  
Medication Regimen ◽  
Therapy Management ◽  
Management Intervention ◽  
Medication Therapy ◽  
Patient Level ◽  
Medication Regimen Complexity ◽  
Complexity Index ◽  
Regimen Complexity

Medication Regimen Complexity Index

2020 ◽  
Vol 35 (2) ◽  
pp. 50-51
Author(s):  
Wei Terk Chang
Keyword(s):  
Clinical Practice ◽  
Pharmaceutical Care ◽  
Care Service ◽  
Medication Therapy Management ◽  
Medication Regimen ◽  
Medication Therapy ◽  
Medication Regimen Complexity ◽  
Complexity Index ◽  
Regimen Complexity ◽  
Pharmaceutical Care Service

This complexity index could be used in clinical practice to more accurately target patients who would benefit from intensive pharmaceutical care service such as medication therapy management.

scholarly journals High level of medication regimen complexity index correlate with worse quality of life in people living with HIV

2021 ◽  
Author(s):  
Enrique Contreras-Macías ◽  
◽  
Antonio Gutiérrez-Pizarraya ◽  
María Aguas Robustillo-Cortés ◽  
Ramón Morillo-Verdugo
Keyword(s):  
Quality Of Life ◽  
Outpatient Service ◽  
Care Plan ◽  
People Living With Hiv ◽  
Medication Regimen ◽  
Medication Regimen Complexity ◽  
Complexity Index ◽  
Regimen Complexity ◽  
Living With Hiv

Objectives. People living with HIV (PLWHIV) have now a near-normal life expectancy and thus, a higher risk of polypharmacy. The main objective was to assess the correlation between medication regimen complexity index (MRCI) and quality of life (EQ-5D) and health utilities among PLWHIV patients on ART. Patients and methods. Observational prospective single-center study including adult PLWHIV on ART from January to March-2020 attended at hospital pharmacy outpatient service according to a Capacity-Motivation-Opportunity (CMO) pharmaceutical care model. Results. A total of 428 patients were included, mean age of 50 ± 10.9 years, 82.2% males. Negative correlation (r2=−0.147; p= 0.0002) between MRCI and EQ-5D was found. Relationship between the comorbidity pattern and quality of life, was also observed. Regarding MRCI, Anxiety/Depression, Pain/discomfort and Self-Care were the dimensions with the worst assessment. Conclusions. A new multidimensional revised care plan for PLWHIV focussed on optimising overall patient care, not limited to viral load goal achievement alone but also in their pharmacotherapeutic complexity and quality of life is needed.

scholarly journals Polypharmacy and high Medication Regimen Complexity Index in the elderly assisted in primary health care / Polifarmácia e Índice de Complexidade Farmacoterapêutico elevado em idosos atendidos na atenção básica de saúde / Polifarmacia y alto Índice de Complejidad Farmacoterapéutica en personas mayores asistidas en la atención..

2020 ◽  
Vol 9 ◽  
Author(s):  
Kananda Pizano De Freitas ◽  
Márcia Regina Martins Alvarenga
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
The Elderly ◽  
Medication Regimen ◽  
Medication Regimen Complexity ◽  
Primary Health ◽  
Complexity Index ◽  
Regimen Complexity

Objetivo: identificar a associação entre polifarmácia e Índice de Complexidade Farmacoterapêutico (ICFT) elevado em idosos atendidos na atenção básica de saúde. Metodologia: pesquisa transversal realizada nas Unidades Básicas de Saúde de Dourados, MS, com idosos. As variáveis pesquisadas foram socioeconômicas, condições de saúde, uso de medicamentos e complexidade da farmacoterapia. Dados analisados por meio de estatística descritiva e correlação de Pearson. Aprovação do Comitê de Ética em pesquisa nº 1.406.745. Resultados: entrevistados 16 idosos em situação de polifarmácia e portadores de alguma doença crônica não transmissivel. O ICFT obteve média 16,96 (± 9,186) e mediana 15,75, que foi adotada como ponto de corte para identificar complexidade do esquema farmacoterapêutico elevado. Oito idosos apresentaram dificuldades para cumprir o esquema terapêutico devido a múltiplas doses no mesmo horário e recordarem-se das medicações. Conclusão: prevalência de idosas, com hipertensão arterial, baixa escolaridade e que precisam de orientação dos profissionais de saúde frente às dificuldades apresentadas quanto à terapia medicamentosa.Descritores: Saúde do idoso. Tratamento farmacológico. Atenção Primária à Saúde.

Identification of the Medication Regimen Complexity Index as an Associated Factor of Nonadherence to Antiretroviral Treatment in HIV Positive Patients

2018 ◽  
Vol 52 (9) ◽  
pp. 862-867 ◽  
Author(s):  
Mercedes Manzano-García ◽  
Concepción Pérez-Guerrero ◽  
Maria Álvarez de Sotomayor Paz ◽  
Mª de las Aguas Robustillo-Cortés ◽  
Carmen Victoria Almeida-González ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Treatment ◽  
Daily Practice ◽  
Concomitant Treatment ◽  
Medication Regimen ◽  
Associated Factor ◽  
Medication Regimen Complexity ◽  
Complexity Index ◽  
Regimen Complexity ◽  
The Impact

Background: Multiple studies have identified a relationship between the complexity of a medication regimen and non-adherence. However, most studies in people who live with HIV (PLWH) have focused on antiretroviral use and have failed to consider the impact of other medications. Objective: The aim of our study is to identify the Medication Regimen Complexity Index (MRCI) as an associated factor for nonadherence to antiretroviral treatment (ART). The secondary aim is to analyze the relationship between clinical and pharmacotherapeutical variables and adherence to antiretroviral treatment and to generate an adherence model. Methods: A transversal, observational study. Patients included were PLWH over 18 years of age on active antiretroviral therapy. Patients who participated in clinical trials or who did not meet the inclusion criteria were excluded. We had studied HIV transmission mode, viral load, treatment status, number of comorbidities and complexity index as factors associated with adherence to ART. Results: We included 619 patients in the study. Number of comorbidities ( p = 0.021; OR = 1.038-1.570); viral load ( p = 0.023; OR = 1.108-4.505) and MRCI ( p < 0.001; OR = 1.138-1.262) (ART and concomitant treatment) were the independent associated factors to ART nonadherence. The value of the Hosmer and Lemeshow test confirmed the validity of this model (P = 0.333). Conclusion: A higher MRCI was associated with non-adherence. Therefore, the regimen complexity calculation may be appropriate in daily practice for identifying patients at a higher risk of becoming non-adherent.

Are Clinical Outcomes Associated With Medication Regimen Complexity? A Systematic Review and Meta-analysis

2019 ◽  
Vol 54 (4) ◽  
pp. 301-313 ◽  
Author(s):  
Vanessa Alves-Conceição ◽  
Kérilin Stancine Santos Rocha ◽  
Fernanda Vilanova Nascimento Silva ◽  
Rafaella de Oliveira Santos Silva ◽  
Sabrina Cerqueira-Santos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Case Control ◽  
Current Evidence ◽  
Medication Regimen ◽  
Medication Regimen Complexity ◽  
Complexity Index ◽  
Regimen Complexity

Background: Current evidence of the influence of the medication regimen complexity (MRC) on the patients’ clinical outcomes are not conclusive. Objective: To systematically and analytically assess the association between MRC measured by the Medication Regimen Complexity Index (MRCI) and clinical outcomes. Methods: A search was carried out in the databases Cochrane Library, LILACS, PubMed, Scopus, EMBASE, Open Thesis, and Web of Science to identify studies evaluating the association between MRC and clinical outcomes that were published from January 1, 2004, to April 2, 2018. The search terms included outcome assessment, drug therapy, and medication regimen complexity index and their synonyms in different combinations for case-control and cohort studies that used the MRCI to measure MRC and related the MRCI with clinical outcomes. Odds ratios (ORs), hazard ratios (HRs), and mean differences (WMDs) were calculated, and heterogeneity was assessed using the I2 test. Results: A total of 12 studies met the eligibility criteria. The meta-analysis showed that MRC is associated with the following clinical outcomes: hospitalization (HR = 1.20; 95% CI = 1.14 to 1.27; I2 = 0%) in cohort studies, hospital readmissions (WMD = 7.72; 95% CI = 1.19 to 14.25; I2 = 84%) in case-control studies, and medication nonadherence (adjusted OR = 1.05; 95% CI = 1.02 to 1.07; I2 = 0%) in cohort studies. Conclusion and Relevance: This systematic review and meta-analysis gathered relevant scientific evidence and quantified the combined estimates to show the association of MRC with clinical outcomes: hospitalization, hospital readmission, and medication adherence.

Medication Regimen Complexity and A1C Goal Attainment in Underserved Adults With Type 2 Diabetes

2016 ◽  
Vol 51 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Alicia Yeh ◽  
Bijal Shah-Manek ◽  
Kajua B. Lor
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Smoking Status ◽  
Medication Regimen ◽  
Antidiabetic Medication ◽  
Patient Level ◽  
Medication Regimen Complexity ◽  
Regimen Complexity ◽  
Specific Medication

Background: From 2009 to 2012, 51.8% of American adults with diabetes had a hemoglobin A1C (A1C) >7.0%. The complexity of antidiabetic medication regimens may have an impact on glycemic control. Objective: The primary objective was to test the hypothesis that higher diabetes-specific medication regimen complexity index (MRCI) was associated with lower attainment of A1C goal <7.0% in an underserved, predominantly Hispanic population of adults with type 2 diabetes. Secondary analyses included less stringent A1C goals of <8.0% and <9.0% and overall patient-level MRCI. Methods: This study was a retrospective, observational, cross-sectional study of individuals with type 2 diabetes from January 2011 to January 2016. Data was obtained from the electronic medical record and MRCI was calculated using the 65-item validated Microsoft Access Version 1.0 medication regimen complexity electronic data capture tool. Logistic regression was used to compute unadjusted and adjusted odds ratios. Results: A total of 368 patients were included in the analysis. High diabetes-specific MRCI was associated with lower attainment of A1C goal <7.0% (adjusted OR = 0.09; 95% CI = 0.04-0.18) controlling for age, gender, ethnicity, insurance, body mass index, smoking status, hypertension, and hyperlipidemia. Similar results were obtained for the less stringent A1C goals. However, results for overall patient-level MRCI were mixed. Conclusions: Higher diabetes-specific medication regimen complexity was associated with poorer glycemic control. Simplifying antidiabetic medication regimens, especially where the treatment guidelines give no preference, could be a step toward achieving treatment goals.

Development and psychometric evaluation of the German version of the Medication Regimen Complexity Index (MRCI-D)

2011 ◽  
Vol 18 (3) ◽  
pp. 515-522 ◽  
Author(s):  
Dorit Stange ◽  
Levente Kriston ◽  
Claudia Langebrake ◽  
Lynda K. Cameron ◽  
John D. Wollacott ◽  
...  
Keyword(s):  
Psychometric Evaluation ◽  
German Version ◽  
Medication Regimen ◽  
Medication Regimen Complexity ◽  
Complexity Index ◽  
Regimen Complexity

Cross-cultural Adaptation and Validation of the Medication Regimen Complexity Index Adapted to Spanish

2016 ◽  
Vol 50 (11) ◽  
pp. 918-925 ◽  
Author(s):  
Javier Saez de la Fuente ◽  
Ana Such Diaz ◽  
Irene Cañamares-Orbis ◽  
Estela Ramila ◽  
Elsa Izquierdo-Garcia ◽  
...  
Keyword(s):  
Cultural Adaptation ◽  
Cross Cultural ◽  
Medication Regimen ◽  
Cross Cultural Adaptation ◽  
Medication Regimen Complexity ◽  
Complexity Index ◽  
Regimen Complexity
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