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

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.

Evaluation of Hospital Discharge Prescriptions in the Elderly and Younger Adults Using the Medication Regimen Complexity Index

2019 ◽  
Vol 14 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Sujit Balodiya ◽  
Ashwin Kamath
Keyword(s):  
Elderly Patients ◽  
Hospital Discharge ◽  
Tertiary Care ◽  
The Elderly ◽  
Medication Regimen ◽  
Cross Sectional ◽  
Medication Regimen Complexity ◽  
Complexity Index ◽  
Increased Risk ◽  
Regimen Complexity

Background:Advances in the clinical management of diseases have been accompanied by increasing complexity of treatment regimens. The complexity of medication regimen is of concern for patients as well as doctors as it may adversely affect patient compliance and treatment outcomes. It may result in medication errors, increased utilization of health resources owing to a reduction in treatment effectiveness, and increased risk of therapeutic failure. Objective:This study aimed to assess the complexity of medication regimen prescribed to patients on hospital discharge using the medication regimen complexity index (MRCI). Methods:A cross-sectional, descriptive study was conducted. Hospital discharge prescriptions written for patients discharged from the General Medicine wards of a tertiary care teaching hospital in South India were scored for their complexity using MRCI. The correlation of age and gender with the MRCI scores was also assessed. Patients ≥60 years of age were considered elderly. Results:The median MRCI score for 563 prescriptions studied was 14 (Interquartile range, 9−21). Elderly patients received a significantly more complex medication regimen compared with younger patients (p < 0.001) at the time of hospital discharge. Gender variation was seen with higher MRCI scores in females, but this was not statistically significant in the elderly group. Conclusion:MRCI scores are significantly high in elderly patients at the time of hospital discharge. Although a strong correlation is seen between the number of medications and the MRCI score, the latter helps to distinguish regimen complexity between prescriptions with the same number of medications.

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.

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

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 Medication regimen complexity and readmissions after hospitalization for heart failure, acute myocardial infarction, pneumonia, and chronic obstructive pulmonary disease

2016 ◽  
Vol 4 ◽  
pp. 205031211663242 ◽  
Author(s):  
Nada Abou-Karam ◽  
Chad Bradford ◽  
Kajua B Lor ◽  
Mitchell Barnett ◽  
Michelle Ha ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Acute Myocardial Infarction ◽  
Chronic Obstructive ◽  
Medication Regimen ◽  
Obstructive Pulmonary Disease ◽  
Medication Regimen Complexity ◽  
Complexity Index ◽  
Regimen Complexity

Objectives: Readmission rate is increasingly being viewed as a key indicator of health system performance. Medication regimen complexity index scores may be predictive of readmissions; however, few studies have examined this potential association. The primary objective of this study was to determine whether medication regimen complexity index is associated with all-cause 30-day readmission after admission for heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease. Methods: This study was an institutional review board–approved, multi-center, case–control study. Patients admitted with a primary diagnosis of heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease were randomly selected for inclusion. Patients were excluded if they discharged against medical advice or expired during their index visit. Block randomization was utilized for equal representation of index diagnosis and site. Discharge medication regimen complexity index scores were compared between subjects with readmission versus those without. Medication regimen complexity index score was then used as a predictor in logistic regression modeling for readmission. Results: Seven hundred and fifty-six patients were randomly selected for inclusion, and 101 (13.4%) readmitted within 30 days. The readmission group had higher medication regimen complexity index scores than the no-readmission group ( p < 0.01). However, after controlling for demographics, disease state, length of stay, site, and medication count, medication regimen complexity index was no longer a significant predictor of readmission (odds ratio 0.99, 95% confidence interval 0.97–1.01) or revisit (odds ratio 0.99, 95% confidence interval 0.98–1.02). Conclusion: There is little evidence to support the use of medication regimen complexity index in readmission prediction when other measures are available. Medication regimen complexity index may lack sufficient sensitivity to capture an effect of medication regimen complexity on all-cause readmission.

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