International Journal of Clinical Pharmacy

, Volume 36, Issue 4, pp 750–756 | Cite as

Medication regimen complexity in institutionalized elderly people in an aging society

  • Ana Margarida AdvinhaEmail author
  • Sofia de Oliveira-Martins
  • Vanessa Mateus
  • Sara Grou Pajote
  • Manuel José Lopes
Research Article


Background Complex medication regimens may adversely affect compliance and treatment outcomes. Complexity can be assessed with the medication regimen complexity index (MRCI), which has proved to be a valid, reliable tool, with potential uses in both practice and research. Objective To use the MRCI to assess medication regimen complexity in institutionalized elderly people. Setting Five nursing homes in mainland Portugal. Methods A descriptive, cross-sectional study of institutionalized elderly people (n = 415) was performed from March to June 2009, including all inpatients aged 65 and over taking at least one medication per day. Main outcome measure Medication regimen complexity index. Results The mean age of the sample was 83.9 years (±6.6 years), and 60.2 % were women. The elderly patients were taking a large number of drugs, with 76.6 % taking more than five medications per day. The average medication regimen complexity was 18.2 (±SD = 9.6), and was higher in the females (p < 0.001). The most decisive factors contributing to the complexity were the number of drugs and dosage frequency. In regimens with the same number of medications, schedule was the most relevant factor in the final score (r = 0.922), followed by pharmaceutical forms (r = 0.768) and additional instructions (r = 0.742). Conclusion Medication regimen complexity proved to be high. There is certainly potential for the pharmacist’s intervention to reduce it as part as the medication review routine in all the patients.


Drug therapy complexity Elderly MRCI Nursing homes Portugal 



Special acknowledgment to the cooperation of nursing homes that participated in data Collection.


The authors did not receive any financial support.

Conflicts of interest



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Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2014

Authors and Affiliations

  • Ana Margarida Advinha
    • 1
    Email author
  • Sofia de Oliveira-Martins
    • 1
  • Vanessa Mateus
    • 2
  • Sara Grou Pajote
    • 3
  • Manuel José Lopes
    • 3
  1. 1.iMed.UL - Instituto de Investigação do MedicamentoFaculty of Pharmacy of the University of LisbonLisbonPortugal
  2. 2.Lisbon School of Health TechnologyPolytechnic Institute of LisbonLisbonPortugal
  3. 3.College of Nursing S. João de DeusUniversity of ÉvoraÉvoraPortugal

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