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Multicenter validation of a novel medication-regimen complexity scoring tool.

Andrea Sikora Newsome1,2, Susan E Smith1, William J Olney1

  • 1Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Augusta, GA.

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|June 4, 2021
PubMed
Summary

The Medication Regimen Complexity-Intensive Care Unit (MRC-ICU) tool objectively measures medication complexity in critically ill patients. External validation confirmed its accuracy across different intensive care unit settings.

Keywords:
critical caredrug therapypatient safetypatientspharmacistspharmacypharmacy practice modelscoring tool

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Area of Science:

  • Pharmacoeconomics and Health Outcomes Research
  • Critical Care Medicine
  • Health Services Research

Background:

  • The Medication Regimen Complexity-Intensive Care Unit (MRC-ICU) is a novel tool for objectively assessing medication regimen complexity in critically ill patients.
  • Further validation is needed to determine the MRC-ICU's utility in evaluating the impact of critical care pharmacists on patient outcomes.
  • This study aimed to confirm the external validity of the MRC-ICU scoring tool across multiple institutions and intensive care unit (ICU) settings.

Purpose of the Study:

  • To confirm the external validity of the MRC-ICU scoring tool.
  • To evaluate the MRC-ICU's performance in diverse institutional and ICU settings.
  • To assess the tool's convergent and divergent validity.

Main Methods:

  • A multicenter, prospective, observational study design was employed.
  • Data were collected from electronic medical records and medication administration records for 230 patients across medical and surgical ICUs.
  • Spearman rank-order correlation was used to assess convergent and divergent validity.

Main Results:

  • The MRC-ICU demonstrated appropriate convergent validity with the number of orders and medication orders (P < 0.001).
  • The tool showed appropriate divergent validity, with no significant correlation found with patient age, weight, or gender (P > 0.05).
  • Differences in order volume and MRC-ICU scores were observed between the original and external sites.

Conclusions:

  • External validity of the MRC-ICU has been confirmed in an external site and surgical ICU population.
  • The MRC-ICU scoring tool shows promise for objective measurement of medication regimen complexity.
  • Prospective evaluation is recommended to determine optimal pharmacist utilization.