Development of medication regimen complexity index: Japanese version and application in elderly patients

International Journal of Clinical Pharmacy (2020)Cite this article

Abstract

Background Medication regimen complexity includes various aspects of a regimen, including the dosage form, number of medications and need for additional information for use. Complicated medication regimens cause non-adherence to prescribed medications, making it essential to evaluate medication regimen complexity in older adults to improve adherence to prescribed medications and clinical outcomes. The medication regimen complexity index is currently the most widely used scale for quantifying regimen complexity; however, it has yet to be adopted in Japan. Objective This study aimed to translate the medication regimen complexity index to Japanese and assess its reliability and validity for application in elderly patients in Japan. Setting This study was conducted in a clinic that provides home medical care to patients in the southern part of Ibaraki prefecture, Japan. Method The validation process consisted of translation of the original English version of the medication regimen complexity index to Japanese followed by back-translation to English, comparison of the back-translated and original versions, pilot testing, and assessment of the Japanese version by two raters using the medication regimens of 72 patients with chronic diseases. Main outcome measure The psychometric properties of the index were evaluated according to inter-rater and test-retest reliability, and convergent and discriminant validity. Results The mean age of the 72 patients was 84.3 years. The scale showed high inter-rater reliability (intraclass correlation coefficient 0.946) and test-retest reliability (intraclass correlation coefficient 0.991) for total scores. The number of medications was positively correlated with total medication regimen complexity index score (rs = 0.930, P < 0.001). There were no statistically significant differences between age, sex and Charlson Comorbidity Index and medication regimen complexity index score (P > 0.05). Conclusions The Japanese version of the medication regimen complexity index is a reliable and valid tool for assessing the complexity of medication regimen in Japanese elderly patients.

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Acknowledgements

The authors would like to thank Dr. Johnson George, the developer of the original version of the MRCI, for providing permission to translate the MRCI to Japanese.

Funding

This study was supported by JSPS Grant-in-Aid for Scientific Research Grant Number 19K16940.

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Affiliations

  1. Department of Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan

    Shoichi Masumoto

  2. Department of General Medicine, Tsukuba Central Hospital, Ushiku, Japan

    Shoichi Masumoto

  3. Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan

    Mikiya Sato

  4. Health Services Center, Human Resources Group, Sumitomo Heavy Industries, Ltd., Tokyo, Japan

    Mikiya Sato

  5. Department of Pharmacy, Showa University Hospital, Tokyo, Japan

    Kenji Momo, Kosuke Suzuki, Hiroshi Shimamura & Tadanori Sasaki

  6. Welcia Yakkyoku Co. Ltd., Tokyo, Japan

    Aya Matsushita

  7. Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan

    Jun Hamano

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  1. Shoichi Masumoto
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  2. Mikiya Sato
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  3. Kenji Momo
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  5. Kosuke Suzuki
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  6. Hiroshi Shimamura
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  7. Tadanori Sasaki
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  8. Jun Hamano
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Correspondence to Shoichi Masumoto.

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Masumoto, S., Sato, M., Momo, K. et al. Development of medication regimen complexity index: Japanese version and application in elderly patients. Int J Clin Pharm (2020). https://doi.org/10.1007/s11096-020-01185-z

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Keywords

  • Elderly
  • Japan
  • Medication regimen complexity
  • Polypharmacy
  • Psychometrics