Validation and standardization of the Brazilian version of the Medication Regimen Complexity Index for older adults in primary care

2018 ◽  
Vol 18 (6) ◽  
pp. 853-859 ◽  
Author(s):  
Laís LN Pantuzza ◽  
Maria das Graças B Ceccato ◽  
Micheline R Silveira ◽  
Isabela VL Pinto ◽  
Adriano Max M Reis
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Medication Regimen ◽  
Medication Regimen Complexity ◽  
Complexity Index ◽  
Brazilian Version ◽  
Regimen Complexity

Factors associated with high medication regimen complexity in primary care older adults in Brazil

2019 ◽  
Vol 11 (2) ◽  
pp. 279-287 ◽  
Author(s):  
Laís Lessa Neiva Pantuzza ◽  
Maria das Graças Braga Ceccato ◽  
Edna Afonso Reis ◽  
Micheline Rosa Silveira ◽  
Celline Cardoso Almeida-Brasil ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Medication Regimen ◽  
Factors Associated ◽  
Medication Regimen Complexity ◽  
Regimen Complexity

scholarly journals Complexity of pharmacotherapeutic regimens for older adults in primary care in Brazil: a cross-sectional study

2021 ◽  
Author(s):  
Mariana Carvalho Bilac ◽  
Luiz Santana Passos ◽  
Romana Santos Gama ◽  
Renato Morais Souza ◽  
Welma Wildes Amorim ◽  
...  
Keyword(s):  
Primary Care ◽  
Older People ◽  
Care Setting ◽  
Primary Care Setting ◽  
Cross Sectional Study ◽  
Medication Regimen ◽  
Cross Sectional ◽  
Medication Regimen Complexity ◽  
Complexity Index ◽  
Regimen Complexity

Aims: Adherence to prescribed treatment is important for obtaining the desired outcomes in older people care. Polypharmacy is strictly associated with adherence, and complex pharmacotherapy can lead to poor adherence and unexpected outcomes, which are aggravated by older age. The medication regimen complexity index has been proven to be a valid and reliable tool for quantifying the complexity of medication regimens. The objective of the present study was to evaluate the therapeutic complexity of drugs used by older people in a primary care setting in Brazil. Methods: This was a cross-sectional study conducted in 22 basic health units in Brazil. Older people from this sample who were treated in a primary care setting were interviewed after a consultation with a family practice physician. Data were collected from September 2016 to March 2019. Patients aged ≥ 60 years who visited the primary care units were included in the study. Pharmacotherapeutic complexity was assessed according to the medication regimen complexity index. Results: In all, 675 individuals with a mean age of 70 years (±7.1 years) were included. The mean number of drugs prescribed per capita was 2.9 (±1.8). The median medication regimen complexity index for the sample was 8.0, and 26.1% of the patients interviewed had a high medication regimen complexity index. Conclusion: The complexity of the drug regimen was high in almost one-third of the prescriptions analysed. This high complexity might contribute to non-adherence to medication regimens, leading to safety- and effectiveness-related issues. Key words: drug prescriptions, geriatrics, pharmaceutical preparations, polypharmacy, primary health care, older patient.

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.

scholarly journals Medication regimen complexity in ambulatory older adults with heart failure

2017 ◽  
Vol Volume 12 ◽  
pp. 679-686 ◽  
Author(s):  
Michael Cobretti ◽  
Robert Page II ◽  
Sunny Linnebur ◽  
Kimberly Deininger ◽  
Amrut Ambardekar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Medication Regimen ◽  
Medication Regimen Complexity ◽  
Regimen Complexity

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.

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.

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.

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
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