scholarly journals ADDRESSING MEDICATION REGIMEN COMPLEXITY IN SKILLED HOME HEALTH CARE

2016 ◽  
Vol 56 (Suppl_3) ◽  
pp. 41-41
2020 ◽  
Vol 35 (2) ◽  
pp. 81-84
Author(s):  
Megan Lenz ◽  
Jeffrey A. Clark ◽  
Brian J. Gates

An interprofessional, team-based approach has become common in a variety of settings. However, consultant pharmacist participation in home health care (HHC) has been limited. To evaluate a potential need for pharmacists in HHC, the objective of this project was to document the medication complexity of patients seen by an established HHC consultant pharmacist service. This retrospective review reports on medication regimen complexity in 79 patients receiving this service using the Patient-Level Medication Regimen Complexity Index (MRCI) tool. The average MRCI score was 30 (± 15 standard deviation), suggesting a high level of medication regimen complexity in this population. High scores have been correlated with increased potential adverse drug events, 30-day hospital readmissions, and reduced adherence. Further research is needed for both the utilization of consultant pharmacists in HHC and the use of MRCI in identifying HHC patients needing pharmacist services.


2020 ◽  
Vol 35 (2) ◽  
pp. 81-84
Author(s):  
Megan Lenz ◽  
Jeffrey A. Clark ◽  
Brian J. Gates

An interprofessional, team-based approach has become common in a variety of settings. However, consultant pharmacist participation in home health care (HHC) has been limited. To evaluate a potential need for pharmacists in HHC, the objective of this project was to document the medication complexity of patients seen by an established HHC consultant pharmacist service. This retrospective review reports on medication regimen complexity in 79 patients receiving this service using the Patient-Level Medication Regimen Complexity Index (MRCI) tool. The average MRCI score was 30 (± 15 standard deviation), suggesting a high level of medication regimen complexity in this population. High scores have been correlated with increased potential adverse drug events, 30-day hospital readmissions, and reduced adherence. Further research is needed for both the utilization of consultant pharmacists in HHC and the use of MRCI in identifying HHC patients needing pharmacist services.


2020 ◽  
Vol 9 ◽  
Author(s):  
Kananda Pizano De Freitas ◽  
Márcia Regina Martins Alvarenga

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.


SAGE Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 215824402092437
Author(s):  
Jesus Ruiz Ramos ◽  
Ana María Juanes Borrego ◽  
Marta Blazquez Andion ◽  
Maria Antonia Mangues Bafalluy ◽  
Mireia Puig Campmany

Different scales have been validated to assess the medication regimen complexity. However, the effect of this complexity on the risk of health care center consultations in patients with drug-related problems is unknown. This study’s objective is to evaluate the association between the Medication Regimen Complexity Index (MCRI) and the number of drugs prescribed and new consultations to the health care system in patients who visit an emergency service due to drug-related problems. This is a retrospective observational study. We included patients >65 years who attended in an emergency service for drug-related problems. To identify variables associated with health care center reconsultation, a multivariate analysis was performed, including demographic and comorbidity variables, number of drugs prescribed, and MCRI value. Two hundred and one patients were included. A significant association was found between the prescription of more than five drugs (odds ratio [OR] = 2.50, 95% confidence interval [CI] = [1.08, 5.79]), an MCRI > 20 (2.98 [1.46–6.09]), and an increase in the number of drugs prescribed (2.87 [1.57–5.21]) and its MCRI (2.06 [1.13–3.77]) at discharge and a new visit to the emergency department. An association was found between the prescription of more than five drugs, an MCRI > 20, an increase in the number of drugs, and in MCRI value at discharge and a new visit to any other health care center. The number of prescribed drugs and the medication complexity of patients who visit the emergency department for drug-related problems was associated with an increase in the number of revisits to the emergency department and to other health care centers.


2020 ◽  
Author(s):  
Abdulaziz A Alodhayani ◽  
Marwah Mazen Hassounah ◽  
Fatima R Qadri ◽  
Noura A Abouammoh ◽  
Zakiuddin Ahmed ◽  
...  

BACKGROUND There is growing evidence of the need to consider cultural factors in the design and implementation of digital health interventions. However, there is still inadequate knowledge pertaining to what aspects of the Saudi Arabian culture need to be considered in the design and implementation of digital health programs, especially in the context of home health care services for chronically and terminally ill patients. OBJECTIVE This study aims to explore the specific cultural factors relating to patients and their caregivers from the perspective of physicians, nurses, and trainers that have influenced the pilot implementation of Remotely Accessible Healthcare At Home (RAHAH); a connected health program in the Home Health Care Department at King Saud University Medical City, Riyadh, Saudi Arabia. METHODS A qualitative study design was adopted to conduct a focus group discussion (FGD) in July 2019 using a semi-structured interview guide with 3 female and 4 male participants working as nurses, family physicians, and information technologists. Qualitative data obtained were analyzed using a thematic framework analysis. RESULTS Two categories emerged from the FGD that influenced the experiences of digital health program intervention: (1) culture-related factors including language and communication, cultural views on using cameras during consultation, non-adherence to online consultations, and family role and commitment (2) caregiver characteristics in telemedicine that includes their skills and education and electronic literacy. Participants of this study revealed that indirect contact with the patients and their family members may work as a barrier to proper communication through RAHAH. CONCLUSIONS We recommend exploring the use of interpreters in digital health, creating awareness among the local population regarding privacy in digital health, and actively involving the direct family members with the healthcare providers.


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