Complexity of the medication regimen for polypathological patients

Area of Science:

• Gerontology
• Internal Medicine
• Clinical Pharmacy

Background:

• Polypathological patients, defined by multiple comorbidities, present significant challenges in healthcare management.
• Polypharmacy is common in these patients, leading to complex therapeutic regimens.
• Assessing and understanding therapeutic complexity is crucial for optimizing patient care and safety.

Purpose of the Study:

• To evaluate the complexity of therapeutic drug regimens in hospitalized polypathological patients.
• To identify factors associated with high therapeutic complexity in this patient population.

Main Methods:

• A multicenter observational study involving 233 polypathological patients admitted to internal medicine departments.
• Therapeutic complexity was quantified using the Medication Regimen Complexity Index (MRCI).
• Logistic regression analysis was employed to identify predictors of therapeutic complexity.

Main Results:

• The mean number of drugs consumed was 8.4, with a mean MRCI score of 30.
• Therapeutic regimens were considered complex when the MRCI score fell within the fourth quartile (42.5-80).
• Respiratory diseases were independently associated with increased therapeutic complexity (OR: 4.185), while neurological diseases with permanent mental deficiency were associated with decreased complexity (OR: 0.265).

Conclusions:

• Hospitalized polypathological patients are frequently polymedicated, exhibiting complex therapeutic drug regimens.
• Respiratory conditions significantly contribute to higher therapeutic complexity.
• Cognitive impairment, specifically permanent mental deficiency, was linked to lower therapeutic complexity, suggesting a need for tailored management approaches.