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Medication regimen complexity index prediction of adverse drug reaction–related hospital admissions
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.
History
Publication title
The Annals of PharmacotherapyVolume
54Issue
10Article number
996–1000Number
996–1000Pagination
1-5ISSN
1060-0280Department/School
School of Pharmacy and PharmacologyPublisher
Harvey Whitney Books CoPlace of publication
Po Box 42696, Cincinnati, USA, Oh, 45242Rights statement
Copyright 2020 The AuthorsRepository Status
- Restricted