Medication Regimen Complexity and Patient-Reported Adherence: A Cross-Sectional Study in Internal Medicine...

Medication non-adherence and regimen complexity are significant barriers to achieving therapeutic goals. This study aimed to determine the impact of medication regimen complexity, and clinical characteristics of patients on medication adherence in internal medicine outpatients.

This prospective cross-sectional study was conducted in the internal medicine and geriatric outpatient clinics of a tertiary university hospital. Adherence was assessed with Medication Adherence Report Scale (MARS-5), and regimen complexity was quantified using the Medication Regimen Complexity Index (MRCI) in 150 patients.

The mean age of the participants was 57.53±1.26 years. Only 44% of the participants demonstrated perfect adherence to therapy. The MRCI scores of geriatric patients (median: 11 (3-44) vs 19 (5-65)) and those hospitalized within the last six months (median: 12.75 (3-47) vs 20 (6-65.5)) were significantly higher. Complexity scores related to dosing schedule and instructions for use were especially higher in patients with hypertension or diabetes. No statistically significant correlation was found between the total MRCI score and patient-reported adherence scores (P=0.32). However, geriatric patients and recently hospitalized patients were less likely to fully adhere to therapy (χ² (1, N=150) = 4.71, P=0.030 and 4.23, P=0.040, respectively).

Although a direct correlation between total regimen complexity and self-reported adherence was not observed, complexity poses a significant challenge for specific high-risk groups, including geriatric patients and those with recent hospitalizations. These findings may suggest that providing targeted medication counseling and medication regimen review, particularly in the early post-discharge period, might be crucial for optimizing adherence and clinical outcomes.