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

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.

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.

scholarly journals Medication-Related Factors and Hospital Readmission in Older Adults with Chronic Kidney Disease

2019 ◽  
Vol 8 (3) ◽  
pp. 395 ◽  
Author(s):  
Wubshet H. Tesfaye ◽  
Gregory M. Peterson ◽  
Ronald L. Castelino ◽  
Charlotte McKercher ◽  
Matthew Jose ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Hospital Readmission ◽  
Hospital Readmissions ◽  
Medication Regimen ◽  
Related Factors ◽  
Medication Regimen Complexity ◽  
Regimen Complexity ◽  
Medication Appropriateness

This study aimed to examine the association between medication-related factors and risk of hospital readmission in older patients with chronic kidney disease (CKD). A retrospective analysis was conducted targeting older CKD (n = 204) patients admitted to an Australian hospital. Medication appropriateness (Medication Appropriateness Index; MAI), medication regimen complexity (number of medications and Medication Regimen Complexity Index; MRCI) and use of selected medication classes were exposure variables. Outcomes were occurrence of readmission within 30 and 90 days, and time to readmission within 90 days. Logistic and Cox hazards regression were used to identify factors associated with readmission. Overall, 50 patients (24%) were readmitted within 30 days, while 81 (40%) were readmitted within 90 days. Mean time to readmission within 90 days was 66 (SD 34) days. Medication appropriateness and regimen complexity were not independently associated with 30- or 90-day hospital readmissions in older adults with CKD, whereas use of renin‒angiotensin blockers was associated with reduced occurrence of 30-day (adjusted OR 0.39; 95% CI 0.19–0.79) and 90-day readmissions (adjusted OR 0.45; 95% CI 0.24–0.84) and longer time to readmission within 90 days (adjusted HR 0.52; 95% CI 0.33–0.83). This finding highlights the importance of considering the potential benefits of individual medications during medication review in older CKD patients.

Factors associated with medication regimen complexity in residents of long-term care facilities

2015 ◽  
Vol 6 (6) ◽  
pp. 561-564 ◽  
Author(s):  
M. Herson ◽  
J.S. Bell ◽  
E.C.K. Tan ◽  
T. Emery ◽  
L. Robson ◽  
...  
Keyword(s):  
Long Term Care ◽  
Medication Regimen ◽  
Term Care ◽  
Factors Associated ◽  
Medication Regimen Complexity ◽  
Regimen Complexity ◽  
Care Facilities

Medication Regimen Complexity and Low Adherence in Older Community-Dwelling Adults With Substantiated Self-Neglect

2017 ◽  
Vol 38 (6) ◽  
pp. 866-883 ◽  
Author(s):  
Sharon Abada ◽  
Leslie E. Clark ◽  
Arup K. Sinha ◽  
Rui Xia ◽  
Kathleen Pace-Murphy ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Linear Regression Analysis ◽  
Community Dwelling ◽  
Medication Regimen ◽  
Protective Services ◽  
Cross Sectional ◽  
Adult Protective Services ◽  
Medication Regimen Complexity ◽  
Regimen Complexity ◽  
Multivariable Linear Regression Analysis

Objective: Determine whether medication regimen complexity predicts medication adherence levels in a sample of community-dwelling adults 65 years and older with Adult Protective Services–substantiated self-neglect. Methods: A cross-sectional analysis of baseline data ( N = 31 participants) from a pilot intervention to increase medication adherence among the target group was performed. The Medication Regimen Complexity Index (MRCI) and the 8-item Morisky Medication Adherence Scale (MMAS-8)™ were the primary independent and dependent measures, respectively. A multivariable linear regression analysis, adjusting for potential confounders, was conducted to estimate the association between complexity and adherence. Results: Regimen complexity was high (mean MRCI = 19.6) and adherence was low (mean MMAS = 5.1). Even after controlling for confounders, increased complexity was significantly associated with lower adherence. Discussion: Older community-dwelling adults who self-neglect have complex medication regimens that contribute to low medication adherence. Medication regimen complexity may be a modifiable contributor to low adherence that can be targeted by future interventions to reduce self-neglect and its consequences.

scholarly journals A Cross-Sectional Assessment of Urinary Tract Infections Among Geriatric Patients: Prevalence, Medication Regimen Complexity, and Factors Associated With Treatment Outcomes

2021 ◽  
Vol 9 ◽  
Author(s):  
Ali Akhtar ◽  
Mohamed Azmi Ahmad Hassali ◽  
Hadzliana Zainal ◽  
Irfhan Ali ◽  
Amer Hayat Khan
Keyword(s):  
Older Adults ◽  
Urinary Tract ◽  
Treatment Outcomes ◽  
Medication Regimen ◽  
Cross Sectional ◽  
Factors Associated ◽  
Medication Regimen Complexity ◽  
Regimen Complexity ◽  
Study Population ◽  
Tract Infections

Background: Urinary tract infections (UTIs) are the second most prevalent infection among the elderly population. Hence, the current study aimed to evaluate the prevalence of UTIs among older adults, medication regimen complexity, and the factors associated with the treatment outcomes of elderly patients infected with UTIs.Methods: A retrospective cross-sectional study was conducted at the Department of Urology, Hospital Pulau Pinang, Malaysia. The patients ≥65 years of age were included in the present study with a confirmed diagnosis of UTIs from 2014 to 2018 (5 years).Results: A total of 460 patients met the inclusion criteria and were included in the present study. Cystitis (37.6%) was the most prevalent UTI among the study population followed by asymptomatic bacteriuria (ASB) (31.9%), pyelonephritis (13.9%), urosepsis (10.2%), and prostatitis (6.4%). Unasyn (ampicillin and sulbactam) was used to treat the UTIs followed by Bactrim (trimethoprim/sulfamethoxazole), and ciprofloxacin. The factors associated with the treatment outcomes of UTIs were gender (odd ratio [OR] = 1.628; p = 0.018), polypharmacy (OR = 0.647; p = 0.033), and presence of other comorbidities (OR = 2.004; p = 0.002) among the study population.Conclusion: Cystitis is the most common UTI observed in older adults. Gender, the burden of polypharmacy, and the presence of comorbidities are the factors that directly affect the treatment outcomes of UTIs among the study population.

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.

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