Anne M. Libby|Douglas N. Fish|Patrick Hosokawa|Sunny A. Linnebur|Kelli R. Metz|Kavita Nair|Joseph J. Saseen|Joseph P. Vande Griend|Sara P. Vu|J. E. Hirsch
Patient-Level Medication Regimen Complexity Across Populations With Chronic Disease
University of Colorado Anschutz Medical Campus|University of Montana|University of Montana|University of Colorado Anschutz Medical Campus|University of Colorado Anschutz Medical Campus|University of Montana|University of Colorado Anschutz Medical Campus|University of Montana|University of Colorado Anschutz Medical Campus|University of Montana|University of Colorado Anschutz Medical Campus|University of Montana|University of Colorado Anschutz Medical Campus|University of Montana|University of Colorado Anschutz Medical Campus|University of Montana|University of Colorado Anschutz Medical Campus|University of Montana|University of California, San Diego
backgroundexpected treatment effectiveness medications diminished due suboptimal adherence medication nonadherence linked pill burden quantity medications however medication regimens similar quantities medications vary complexity due multiple dosage forms frequency dosing additional usage directions thus simple medication count ignores medication regimen complexity especially pertains patientlevel perspective includes prescription overthecounter medications gap exists study patientlevel medication regimen complexity metric across diseasespecific populationsobjectivethe goal study implement quantitative medication regimen complexity index mrci patient level defined populations chronic disease geriatric depression hiv diabetes mellitus hypertension patientlevel medication regimen complexity included prescribed medications overthecounter medications documented electronic medication listmethodsusing electronic medical records university colorado hospital ambulatory clinics sampled 4 retrospective cohorts adult patients active care 2011 qualifying medical diagnosis prescribed diseasespecific medication samples randomly selected qualifying patients deidentified information coded using mrciresultscohortdefining diseasespecific prescription medications eg antidepressants depressiondefined cohort contributed 20 total patientlevel complexity mrci score mrci score dominated complexity associated prescription medications within diseasespecific cohorts mrci scores differentiated patients highest lowest medication counts comorbidity counts charlson comorbidity index scores example geriatric depression patients highest quartile mean mrci score 41 lowest quartile mean mrci score 13 diseasespecific cohorts high low mrci scores differed cohort mrci ranges example highest quartile mrci scores varied mean mrci score 41 geriatric depression 30 hypertension lowest quartile scores ranged mean mrci score 7 hypertension hiv 13 geriatric depressionconclusionsmrci components dosing frequency prescribed medications outside cohortdefining disease medications contributed patientlevel scores thus chronic disease management programs may want consider medications patients taking examine ways reduce complexity reducing multiple dosing frequencies possible mrci scores differentiated high low patientlevel complexity measures representing possible utility prospective tool identify target patients intervention future work includes simplifying mrci enhancing scores medication risk factors well explicitly linking adherence health services