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Medication regimen complexity in institutionalized elderly people in an aging society

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Abstract

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.

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Acknowledgments

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

Funding

The authors did not receive any financial support.

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Authors and Affiliations

  1. iMed.UL - Instituto de Investigação do Medicamento, Faculty of Pharmacy of the University of Lisbon, Avenida Professor Gama Pinto, 1649-003, Lisbon, Portugal

    Ana Margarida Advinha & Sofia de Oliveira-Martins

  2. Lisbon School of Health Technology, Polytechnic Institute of Lisbon, Avenida D. João II, Lote 4.69.01, 1990-096, Lisbon, Portugal

    Vanessa Mateus

  3. College of Nursing S. João de Deus, University of Évora, Largo do Senhor da Pobreza, 7000-811, Évora, Portugal

    Sara Grou Pajote & Manuel José Lopes

Authors
  1. Ana Margarida Advinha
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  2. Sofia de Oliveira-Martins
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  3. Vanessa Mateus
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  4. Sara Grou Pajote
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  5. Manuel José Lopes
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Correspondence to Ana Margarida Advinha.

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Advinha, A.M., de Oliveira-Martins, S., Mateus, V. et al. Medication regimen complexity in institutionalized elderly people in an aging society. Int J Clin Pharm 36, 750–756 (2014). https://doi.org/10.1007/s11096-014-9963-4

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  • DOI: https://doi.org/10.1007/s11096-014-9963-4

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