scholarly journals Medication regimen complexity and medication adherence in elderly patients with chronic kidney disease

2019 ◽  
Vol 23 (3) ◽  
pp. 333-342 ◽  
Author(s):  
Krystina Parker ◽  
Ingrid Bull-Engelstad ◽  
Willy Aasebø ◽  
Nanna von der Lippe ◽  
Morten Reier-Nilsen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Medication Adherence ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Medication Regimen ◽  
Medication Regimen Complexity ◽  
Regimen Complexity

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.

scholarly journals Medication Regimen Complexity and Hospital Readmission in Older Adults With Chronic Kidney Disease

2018 ◽  
Vol 53 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Wubshet H. Tesfaye ◽  
Gregory M. Peterson ◽  
Ronald L. Castelino ◽  
Charlotte McKercher ◽  
Matthew D. Jose ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Hospital Admissions ◽  
Tertiary Care ◽  
Care Hospital ◽  
Medication Regimen ◽  
Related Factors ◽  
Medication Regimen Complexity ◽  
Regimen Complexity

Background: Chronic kidney disease (CKD) is characterized by high rates of hospital admissions and readmissions. However, there is a scarcity of research into medication-related factors predicting such outcomes in this patient group. Objective: To evaluate the effect of medication regimen complexity at hospital discharge on subsequent readmissions and their timing in older adults with CKD. Methods: This was a 12-month retrospective cohort study of 204 older (⩾65 years) CKD patients in an Australian tertiary care hospital. Medication regimen complexity was quantified using the 65-item medication regimen complexity index (MRCI). The outcomes were the occurrence of readmission in 30 days and time to readmission within 12 months. Logistic regression was used to identify factors predicting 30-day readmission, and a competing risks proportional subdistribution hazard model, accounting for deaths, was used for factors predicting time to readmission. Results: Overall, 50 (24%) patients, predominantly men (72%), were readmitted within 30 days of follow-up. MRCI was not significantly associated with 30-day readmission (odds ratio [OR] = 1.27; 95% CI = 0.94-1.73). The median (interquartile range) time to readmission within 12 months was 145 (31-365) days. On a multivariate analysis, a 10-unit increase in MRCI was associated with a shorter time to readmission within 12 months (subdistribution HR = 1.18; 95% CI = 1.01-1.36). Conclusion and Relevance: Medication regimen complexity was not significantly associated with 30-day readmission; however, it was associated with a significantly shorter time to 12-month readmission in older CKD patients. This finding highlights the importance of medication regimen complexity as a potential target for medical interventions to reduce readmission risks.

Medication Regimen Complexity and Medication Adherence In Patients with Polypharmacy

2021 ◽  
Vol 11 (2) ◽  
pp. 130-135
Author(s):  
Ms.K.Gnana Swarupini ◽  
Dr.G.RamyaBala Prabha ◽  
Ms.Dharmapuram Santhosha ◽  
Ms. Nadimidoddi Hepciba
Keyword(s):  
Medication Adherence ◽  
Medication Regimen ◽  
Medication Regimen Complexity ◽  
Regimen Complexity

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 Effect of number of medications and complexity of regimens on medication adherence and blood pressure management in hospitalized patients with hypertension

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252944
Author(s):  
Eri Wakai ◽  
Kenji Ikemura ◽  
Chika Kato ◽  
Masahiro Okuda
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Therapeutic Efficacy ◽  
University Hospital ◽  
Pressure Management ◽  
Medication Regimen ◽  
Good Adherence ◽  
Blood Pressure Management ◽  
Medication Regimen Complexity ◽  
Regimen Complexity

Introduction Good adherence of antihypertensives is recommended for the accomplishment of hypertension therapy. The number of medications and characteristics contributing to medication regimen complexity, such as dosage forms and dosing frequency, are known to influence medication adherence. However, the effect of medication regimen complexity on the therapeutic efficacy of medicines remains to be clarified. In the present study, we retrospectively investigated the effect of number of medications and medication regimen complexity on medication adherence and therapeutic efficacy in patients with hypertension. Methods According to the inclusion and exclusion criteria, 1,057 patients, who were on medications including antihypertensives on admission at the Mie University Hospital between July 2018 and December 2018, were enrolled in this study. Poor blood pressure management was defined if the systolic or diastolic blood pressure were ≥140 mmHg or ≥ 90 mmHg. Medication regimen complexity was quantified using the medication regimen complexity index (MRCI) score. Results Among 1,057 patients, 164 and 893 patients were categorized into poor and good adherence groups, respectively. The multivariate analyses revealed that age ≥ 71 years and oral MRCI score ≥ 19.5 but not number of oral medications were extracted as risk factors for poor medication adherence. Medication adherence and blood pressure management were poor in the group with oral MRCI score ≥ 19.5, regardless of the age. The rate of readmission was similar. Conclusion Our study is the first to demonstrate that medication regimen complexity rather than number of medications is closely related to medication adherence and blood pressure management. Hence, physicians and/or pharmacists should consider the complexity of medication regimens while modifying them.

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.

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