Patient-level medication regimen complexity in older adults with depression

Area of Science:

• Geriatric Medicine
• Psychiatric Pharmacy
• Health Services Research

Background:

• Polypharmacy and medication adherence are significant challenges for older adults.
• Medication regimen complexity increases self-care demands in the home environment.
• Features influencing medication regimen complexity in older adults with depression are not well understood.

Purpose of the Study:

• To investigate the features of medication regimens that most influence complexity in older adults diagnosed with depression.
• To characterize medication regimen complexity beyond just the number of medications prescribed.

Main Methods:

• A cohort of 100 adults aged 65+ with depression was selected from electronic medical records.
• Demographic, medical history, and medication data were extracted.
• Medication Regimen Complexity Index (MRCI) was used to determine complexity.

Main Results:

• The mean number of medications was 7.1-8.0, with 66-70% taking six or more medications.
• Dosing frequency accounted for 57-58% of the MRCI score, with an average of 7-8 unique dosing frequencies.
• An average of 3 additional directions were noted per regimen to clarify dosing.

Conclusions:

• Older adults with depression commonly take multiple medications, leading to complex regimens.
• Complexity is driven by dosing forms, frequencies, and additional usage instructions.
• Assessing entire medication regimens, not just depression-specific drugs, is crucial for reducing complexity and improving self-care.