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Medication Regimen Complexity Index Prediction of Adverse Drug Reaction-Related Hospital Admissions

Colin M Curtain1, Jie Yi Chang1, Justin Cousins1

  • 1University of Tasmania, Hobart, Tasmania, Australia.

The Annals of Pharmacotherapy
|May 1, 2020
PubMed
Abstract

Insights

The medication regimen complexity index (MRCI) and medication count do not effectively predict adverse drug reaction (ADR)-related hospital admissions in older adults. Neither measure alone helps clinicians identify patients at risk for ADRs.

Area of Science:

  • Geriatric Medicine
  • Pharmacology
  • Health Services Research

Background:

  • Adverse drug reactions (ADRs) are a significant cause of hospital admissions in older adults.
  • The Medication Regimen Complexity Index (MRCI) is a tool to measure the complexity of a patient's medication regimen.
  • The predictive value of MRCI for ADR-related hospital admissions has not been specifically investigated.

Purpose of the Study:

  • To evaluate the MRCI's ability to predict ADR-related hospital admissions in older patients.
  • To compare the predictive performance of MRCI with simple medication count for ADR-related hospital admissions.

Main Methods:

  • Retrospective analysis of prospectively collected data from 768 unplanned medical admissions in Australians aged 65 years and older.
  • Calculation of MRCI scores from medical records.
  • Comparison of MRCI and medication count in predicting ADR-related admissions versus non-ADR-related admissions.

Main Results:

  • The MRCI score did not significantly differ between ADR-related and non-ADR-related admissions (38.5 vs 34.0, P=0.067).
  • Medication count was significantly higher in ADR-related admissions (12 vs 10, P=0.021), but it was not a strong predictor (OR=1.044).

Conclusions:

  • MRCI scores did not effectively discriminate between ADR-related and other medical admissions.
  • Medication count showed marginal relevance but was not a strong predictor.
  • Neither MRCI nor medication count alone appears useful for clinicians to identify older patients at risk of ADRs.
Keywords:
adverse drug reactionshospital admissionmedication regimen complexityolder patients

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