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Development and assessment of an abbreviated medication regimen complexity index (the A-MRCI)

Rebekah P Scrivens1,2, Ina Liu1,2, Joshua D Niznik3,4

  • 1Department of Pharmacy, UNC Health, Chapel Hill, NC.

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|July 22, 2024
PubMed
Abstract

Insights

An abbreviated medication regimen complexity index (A-MRCI) shows higher scores and better association with patient factors than the original MRCI. This automated tool may improve medication management and patient outcomes.

Area of Science:

  • Pharmacology and Health Services Research
  • Clinical Pharmacy and Patient Outcomes
  • Health Informatics and Electronic Health Records

Background:

  • The Medication Regimen Complexity Index (MRCI) is a tool to assess medication complexity.
  • Automating MRCI in electronic medical records (EMRs) could enhance medication optimization and patient outcomes.
  • Current MRCI adaptation for EMR automation requires evaluation.

Purpose of the Study:

  • To develop and evaluate an abbreviated medication regimen complexity index (A-MRCI).
  • To compare the associations of A-MRCI with patient-level factors against the original MRCI.
  • To assess the potential for EMR integration and automation of medication regimen complexity assessment.

Main Methods:

  • The MRCI was modified through expert panel reviews by clinical pharmacists and outcomes researchers.
  • Medication data from 138 electronic health records were used to calculate MRCI and A-MRCI scores.
  • Inferential statistics compared the indices using data from cardiology and advanced heart failure patients in 2017.

Main Results:

  • A-MRCI scores were significantly higher than MRCI scores (mean difference 3.97, P < 0.0005).
  • A-MRCI scores demonstrated significant associations with length of stay (P = 0.0005) and polypharmacy (P < 0.0005).
  • The original MRCI did not show a demonstrated association with the examined patient-level factors.

Conclusions:

  • The A-MRCI is higher on average and more strongly associated with key patient-level factors than the MRCI.
  • Internal analyses suggest the A-MRCI's potential for automated integration into electronic health records.
  • Further validation of the A-MRCI in a larger, external sample is recommended.
Keywords:
MRCIautomationinterventionmedication adherencepharmacistsscoring tool

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