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

被引:19
作者
Brysch, Emily G. [1 ]
Cauthon, Kimberly A. B. [2 ]
Kalich, Bethany A. [2 ]
Sarbacker, G. Blair [3 ]
机构
[1] South Texas Vet Healthcare Syst, South Bexar Outpatient Clin, 4610 E Southcross, San Antonio, TX 78222 USA
[2] Univ Incarnate Word, Feik Sch Pharm, Pharm Practice, San Antonio, TX USA
[3] Presbyterian Coll, Sch Pharm, Pharm Practice, Clinton, SC USA
来源
CONSULTANT PHARMACIST | 2018年 / 33卷 / 09期
关键词
Geriatrics; Medication adherence; Medication complexity; Medication Regimen Complexity Index;
D O I
10.4140/TCP.n.2018.484
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
OBJECTIVE: To review current literature reporting outcomes associated with utilization of the Medication Regimen Complexity Index (MRCI) with older adults in an outpatient setting. DATA SOURCES: The National Library of Medicine via PubMed, International Pharmaceutical Abstracts, and the Cochrane Database were used to identify clinical trials evaluating outcomes associated with utilization of the MRCI. The medical subject heading terms "geriatrics" and "medication adherence" were used in combination with key terms "medication regimen complexity index" and "medication complexity." STUDY SELECTION/DATA EXTRACTION: Seventy-five articles met the search criteria and were reviewed. Studies were included if they had MRCI-related outcomes and were performed in patients 60 years of age and older in an outpatient setting. Eleven articles met the stated criteria. DATA SYNTHESIS: Higher MRCI scores may be associated with increased mortality rates, medication nonadherence, and unplanned hospitalizations; however, when compared with medication number, MRCI did not better predict increased medication nonadherence and unplanned hospitalizations. CONCLUSION: The MRCI is a useful tool to determine medication complexity; however, current literature is limited by its observational design. Also, MRCI does not take into account potential factors such as high-risk medications and comorbid conditions, which may affect MRCI scores; therefore, additional trials are warranted before suggesting pharmacists implement this tool in their everyday practice.
引用
收藏
页码:484 / 496
页数:13
相关论文
共 24 条
  • [1] Projected Future Growth of Older Population
  • [2] Hajjar E.R., Cafiero A.C., Hanlon J.T., Polypharmacy in elderly patients, Am J Geriatr Pharmacother, 5, pp. 345-351, (2007)
  • [3] Schoonover H., Corbett C.F., Weeks D.L., Et al., Predicting potential postdischarge adverse drug events and 30-day unplanned hospital readmissions from medication regimen complexity, J Patient Saf, 10, pp. 186-191, (2014)
  • [4] Frohlich S.E., Zaccolo A.V., Da Silva S.L.C., Et al., Association between drug prescribing and quality of life in primary care, Pharm World Sci, 32, pp. 744-751, (2010)
  • [5] Guiding principles for the care of older adults with multimorbidity: An approach for clinicians, J Am Geriatr Soc, 60, pp. E1-E25, (2012)
  • [6] George J., Phun Y.-T., Bailey M.J., Et al., Development and validation of the medication regimen complexity index, Ann Pharmacother, 38, pp. 1369-1376, (2004)
  • [7] Conn V.S., Taylor S.G., Kelley S., Medication regimen complexity and adherence among older adults, Image J Nurs Sch, 23, pp. 231-235, (1991)
  • [8] Mansur N., Weiss A., Beloosesky Y., Looking beyond polypharmacy: Quantification of medication regimen complexity in the elderly, Am J Geriatr Pharmacother, 10, pp. 223-229, (2012)
  • [9] Hirsch J.D., Metz K.R., Hosokawa P.W., Et al., Validation of a patient-level medication regimen complexity index as a possible tool to identify patients for medication therapy management intervention, Pharmacother J Hum Pharmacol Drug Ther, 34, pp. 826-835, (2014)
  • [10] Libby A.M., Fish D.N., Hosokawa P.W., Et al., Patient-level medication regimen complexity across populations with chronic disease, Clin Ther, 35, pp. 385-398, (2013)