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.

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.

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.

Multicenter validation of a novel medication-regimen complexity scoring tool

2020 ◽  
Vol 77 (6) ◽  
pp. 474-478
Author(s):  
Andrea Sikora Newsome ◽  
Susan E Smith ◽  
William J Olney ◽  
Timothy W Jones
Keyword(s):  
Patient Outcomes ◽  
External Validity ◽  
Divergent Validity ◽  
Medication Regimen ◽  
Medication Regimen Complexity ◽  
Icu Discharge ◽  
Medical Icus ◽  
Regimen Complexity ◽  
Scoring Tool ◽  
The Impact

Abstract Background The MRC-ICU, a novel regimen complexity scoring tool, provides an objective measure of medication regimen complexity in critically ill patients. The MRC-ICU may have the ability to evaluate the impact of critical care pharmacists on patient outcomes but requires further validation. The objective of this study was to confirm the external validity of the MRC-ICU scoring tool at multiple institutions and intensive care unit (ICU) settings. Methods This was a multicenter, prospective, observational study. The electronic medical record was reviewed to collect patient demographics and patient outcomes, and the medication administration record was reviewed to collect MRC-ICU scores at 24 hours, 48 hours, and ICU discharge. Validation was performed by assessing convergent and divergent validity of the score. Spearman rank-order correlation was used to determine correlation. Results A total of 230 patients were evaluated across both centers in both medical ICUs and surgical ICUs. Differences between the original center and the new site included that total number of orders (29 vs 126; P &lt; 0.001) and total number of medication orders (17 vs 36; P &lt; 0.001) were higher at the new site, whereas the original site had higher overall MRC-ICU scores (14 vs 11; P = 0.004). The MRC-ICU showed appropriate convergent validity with number of orders and medication orders (all P &lt; 0.001) and appropriate divergent validity with no significant correlation found between age, weight, or gender (all P &gt; 0.05). Conclusions External validity of the MRC-ICU has been confirmed through evaluation at an external site and in the surgical ICU population. The MRC-ICU scoring tool requires prospective evaluation to provide objective data regarding optimal pharmacist use.

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

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

scholarly journals THE IMPACT OF MEDICATION REGIMEN COMPLEXITY ON ADHERENCE TO LONG-TERM THERAPIES

2021 ◽  
pp. 40-43
Author(s):  
SHAKEEL AHMAD MIR ◽  
DANISH SHAKEEL
Keyword(s):  
Drug Administration ◽  
Term Therapy ◽  
Medication Regimen ◽  
Related Factors ◽  
Cross Sectional ◽  
Medication Regimen Complexity ◽  
Regimen Complexity ◽  
High Adherence ◽  
The Impact

Objective: Adherence is a multifactorial phenomenon. Medication-related factors have long been the focus of attention. However, the results are inconsistent. Methods: In a cross-sectional questionnaire-based study of outpatients, we assessed 180 patients suffering from chronic conditions. The objective of this study is to determine the impact of medication regimen complexity on adherence to long-term drug therapies. Results: 91.66% of patients receiving more than four drugs had good or high adherence. 80.94% of patients on thrice a day (or more) drug administration had good or high adherence. 91.66% of patients receiving drug therapy for more than 5 years had good or high adherence. In all other groups, the adherence was low. The adherence was significantly (p<0.05) and positively (rs=0.792 and 0.846) correlated to the frequency of drug administration and duration of treatment. Adherence was positively correlated to the number of drugs per day (rs=0.668) but the relationships were not statistically significant (p=0.102). All the correlations were large. Conclusions: We found adherence positively correlated with medication regimen complexity. An improved understanding of the determinants of medication adherence is needed. Keywords: Medication regimen complexity, Adherence, Long-term therapy, Chronic disease

Medication Regimen Complexity Index in the Elderly in an Outpatient Setting: A Literature Review

2018 ◽  
Vol 33 (9) ◽  
pp. 484-496 ◽  
Author(s):  
Emily G. Brysch ◽  
Kimberly A. B. Cauthon ◽  
Bethany A. Kalich ◽  
G. Blair Sarbacker
Keyword(s):  
Literature Review ◽  
The Elderly ◽  
Outpatient Setting ◽  
Medication Regimen ◽  
Medication Regimen Complexity ◽  
Complexity Index ◽  
Regimen Complexity
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