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Factors associated with high medication regimen complexity in primary care older adults in Brazil

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Key summary points

AbstractSection Aim

To investigate the factors associated with high medication regimen complexity in older adults.

AbstractSection Findings

High complexity in older adults was associated with diabetes and asthma/Chronic Obstructive Pulmonary Disease.

AbstractSection Message

Dosing frequency and additional instructions were medication regime complexity index components that most contributed to the high complexity in medication regime of older adults in primary care. Reducing dose frequency is one strategy to simplify the medication regime complexity of older adults in primary care.

Abstract

Purpose

Complex medication regimens are common among older adults and contribute to the occurrence of undesirable health outcomes. This study aims to investigate the factors associated with high medication regimen complexity in older people.

Methods

A cross-sectional study was conducted with older adults selected from two primary healthcare units. Medication regimen complexity was measured using the Brazilian version of the Medication Regimen Complexity Index. The Pearson’s Chi square test was used to analyse the individual association of each independent variable with high medication regimen complexity. The backward stepwise method was used to obtain the final multivariate logistic regression model.

Results

We included 227 older adults with a median age of 70 years who were mostly females (70.9%). The median total Medication Regimen Complexity Index was 20.8 for high complexity and 10.5 for patients that were not using high complexity regimens. The Medication Regimen Complexity Index section with higher median scores in both groups was dosing frequency, followed by additional instructions. High complexity was associated with diabetes (OR 5.42; p = 0.00 2.69–10.93) and asthma/Chronic Obstructive Pulmonary Disease (OR 2.96(1.22–7.18); p = 0.02).

Conclusions

Older people in primary care with diabetes and respiratory disease were most likely to have complex medication regimens. Dosing frequency and additional instructions were medication regime complexity index components that most contributed to the high complexity in medication regime of older adults.

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Acknowledgements

This study was supported by Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG) (APQ-00770-14) and Pró-Reitoria de Pesquisa da Universidade Federal de Minas Gerais (UFMG).

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Authors and Affiliations

  1. Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Faculdade de Farmácia, Universidade Federal de Minas Gerais, 6627 Presidente Antônio Carlos Ave, Pampulha, Belo Horizonte, Minas Gerais, Brazil

    Laís Lessa Neiva Pantuzza

  2. Faculdade de Farmácia, Universidade Federal de Minas Gerais, 6627 Presidente Antônio Carlos Ave, Pampulha, Belo Horizonte, Minas Gerais, Brazil

    Maria das Graças Braga Ceccato, Micheline Rosa Silveira & Adriano Max Moreira Reis

  3. Instituto de Ciências Exatas da Universidade Federal de Minas Gerais, 6627 Presidente Antônio Carlos Ave, Pampulha, Belo Horizonte, Minas Gerais, Brazil

    Edna Afonso Reis

  4. Center for Outcomes Research and Evaluation (CORE), Research Institute at the McGill University Health Centre, 5252 Bd. de Maisonneuve O, Montreal, QC, H4A 3S9, Canada

    Celline Cardoso Almeida-Brasil

  5. Prefeitura Municipal de Belo Horizonte, Farmácia Distrital Leste, 141 Joaquim Felício st., Sagrada Família, Belo Horizonte, Minas Gerais, Brazil

    Thiago Augusto Almeida & Isabela Vaz Leite Pinto

Authors
  1. Laís Lessa Neiva Pantuzza
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  2. Maria das Graças Braga Ceccato
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  3. Edna Afonso Reis
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  4. Micheline Rosa Silveira
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  5. Celline Cardoso Almeida-Brasil
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  6. Thiago Augusto Almeida
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  7. Isabela Vaz Leite Pinto
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  8. Adriano Max Moreira Reis
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Corresponding author

Correspondence to Adriano Max Moreira Reis.

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Conflict of interest

The authors declare no conflicts of interest.

Ethics approval

The study was approved by the Research Ethics Committee of the Federal University of Minas Gerais and the Municipal Health Department of Belo Horizonte (CAAE: 17339713.4.0000.5149). All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Pantuzza, L.L.N., das Graças Braga Ceccato, M., Reis, E.A. et al. Factors associated with high medication regimen complexity in primary care older adults in Brazil. Eur Geriatr Med 11, 279–287 (2020). https://doi.org/10.1007/s41999-019-00275-0

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  • DOI: https://doi.org/10.1007/s41999-019-00275-0

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