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Medication regimen complexity index prediction of adverse drug reaction–related hospital admissions

Curtain, CM ORCID: 0000-0001-5029-7541, Chang, JY, Cousins, J ORCID: 0000-0003-2343-2685, Parameswaran Nair, N ORCID: 0000-0002-0202-6453, Bereznicki, B ORCID: 0000-0001-8463-4817 and Bereznicki, L ORCID: 0000-0003-3974-3437 2020 , 'Medication regimen complexity index prediction of adverse drug reaction–related hospital admissions' , The Annals of Pharmacotherapy , pp. 1-5 , doi: 10.1177/1060028020919188.

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Background: The relationship between the medication regimen complexity index (MRCI) and adverse drug reaction(ADR)-related hospital admissions has not yet specifically been investigated. Objective: To evaluate the MRCI andcompare with medication count for prediction of ADR-related hospital admissions in older patients. Methods: This was aretrospective analysis of a prospectively collected convenience sample of 768 unplanned medical admissions of Australiansaged 65 years old and older. The sample consisted of 115 (15.0%) ADR-related unplanned hospital admissions and 653(85.0%) non–ADR-related unplanned medical admissions. The MRCI score was calculated from the medical records andanalyzed to predict ADR-related hospital admissions. Results: The cohort had a median age of 81 years, 5 comorbidities,and 11 medications, with a slight majority of women. The MRCI score was not significantly different in patients whohad ADR-related admissions compared with other medical admissions—38.5 versus 34.0, respectively; Wilcoxon RankSum test W = 33522; P = 0.067. The medication count was significantly different between the ADR-related admissionscompared with other medical admissions: 12 versus 10; W = 32 508; P = 0.021. However, the medication count wasnot a strong predictor of ADR-related admissions; unadjusted odds ratio = 1.044; 95% CI = 1.006-1.084. Conclusion:and Relevance: The MRCI score did not discriminate between ADR-related admissions and other medical admissionsdespite taking time to calculate with potential for inconsistent application. Medication count is more readily applicablewith marginally greater relevance in this cohort; however, both measures do not appear to be useful when used alone forclinicians to identify patients at risk of ADRs.

Item Type: Article
Authors/Creators:Curtain, CM and Chang, JY and Cousins, J and Parameswaran Nair, N and Bereznicki, B and Bereznicki, L
Keywords: medication regimen complexity, older patients, adverse drug reactions, hospital admission
Journal or Publication Title: The Annals of Pharmacotherapy
Publisher: Harvey Whitney Books Co
ISSN: 1060-0280
DOI / ID Number: 10.1177/1060028020919188
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Copyright 2020 The Authors

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