Complexity of Medicine Regimens and Patient Perception of Medicine Burden

From the patient perspective, medicine burden is more than the number of medicines, or the complexity of medicine regimens they need to manage. Relationships between the number of medicines, regimen complexity and patient perception of medicine burden are under-researched. This cross-sectional study measured regimen complexity and determined how this and patient perceived burden are affected by the therapeutic group. Regimen complexity was measured in patients presenting prescriptions to six community pharmacies in South-East England. A sub-sample (166) also completed the Living with Medicines Questionnaire which measures patient perceived burden. The 492 patients were prescribed 2700 medicines (range 1 to 23). Almost half used at least one non-oral formulation. Complexity was correlated strongly with the number of medicines (r = 0.94), number of therapeutic groups (r = 0.84) and number of formulations (r = 0.73). Patients using medicines for skin, eye and respiratory conditions had the highest complexity scores. Increasing the number of medicines, frequency of dosing, number of non-oral formulations and number of different therapeutic groups all increased medicine burden. Although cardiovascular medicines were the most common medicines used by the majority of patients (60%), those for neurological, psychiatric and gastro-intestinal conditions were most strongly associated with high burden. Studies are required to determine medicine burden in different conditions, especially neurological conditions, including chronic pain.