Curtain, CM and Chang, JY and Cousins, J and Parameswaran Nair, N and Bereznicki, B and Bereznicki, L, Medication regimen complexity index prediction of adverse drug reaction-related hospital admissions, The Annals of Pharmacotherapy pp. 1-5. ISSN 1060-0280 (2020) [Refereed Article]
Background: The relationship between the medication regimen complexity index (MRCI) and adverse drug reaction (ADR)-related hospital admissions has not yet specifically been investigated.
Objective: To evaluate the MRCI and compare with medication count for prediction of ADR-related hospital admissions in older patients.
Methods: This was a retrospective analysis of a prospectively collected convenience sample of 768 unplanned medical admissions of Australians aged 65 years old and older. The sample consisted of 115 (15.0%) ADR-related unplanned hospital admissions and 653 (85.0%) non–ADR-related unplanned medical admissions. The MRCI score was calculated from the medical records and analyzed to predict ADR-related hospital admissions.
Results: The cohort had a median age of 81 years, 5 comorbidities, and 11 medications, with a slight majority of women. The MRCI score was not significantly different in patients who had ADR-related admissions compared with other medical admissions—38.5 versus 34.0, respectively; Wilcoxon Rank Sum test W = 33522; P = 0.067. The medication count was significantly different between the ADR-related admissions compared with other medical admissions: 12 versus 10; W = 32 508; P = 0.021. However, the medication count was not a strong predictor of ADR-related admissions; unadjusted odds ratio = 1.044; 95% CI = 1.006-1.084.
Conclusion: and Relevance: The MRCI score did not discriminate between ADR-related admissions and other medical admissions despite taking time to calculate with potential for inconsistent application. Medication count is more readily applicable with marginally greater relevance in this cohort; however, both measures do not appear to be useful when used alone for clinicians to identify patients at risk of ADRs.
|Item Type:||Refereed Article|
|Keywords:||medication regimen complexity, older patients, adverse drug reactions, hospital admission|
|Research Division:||Medical and Health Sciences|
|Research Group:||Pharmacology and Pharmaceutical Sciences|
|Research Field:||Clinical Pharmacology and Therapeutics|
|Objective Group:||Specific Population Health (excl. Indigenous Health)|
|Objective Field:||Health Related to Ageing|
|UTAS Author:||Curtain, CM (Mr Colin Curtain)|
|UTAS Author:||Chang, JY (Miss Chang)|
|UTAS Author:||Cousins, J (Mr Justin Cousins)|
|UTAS Author:||Parameswaran Nair, N (Dr Nibu Parameswaran Nair)|
|UTAS Author:||Bereznicki, B (Dr Bonnie Bereznicki)|
|UTAS Author:||Bereznicki, L (Professor Luke Bereznicki)|
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