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Olney WJ, Chase AM, Hannah SA, Smith SE, Newsome AS. Medication Regimen Complexity Score as an Indicator of Fluid Balance in Critically Ill Patients. J Pharm Pract 2022; 35:573-579. [PMID: 33685269 DOI: 10.1177/0897190021999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
BACKGROUND Critically ill patients are at increased risk for fluid overload, but objective prediction tools to guide clinical decision-making are lacking. The MRC-ICU scoring tool is an objective tool for measuring medication regimen complexity. OBJECTIVE To evaluate the relationship between MRC-ICU score and fluid overload in critically ill patients. METHODS In this multi-center, retrospective, observational study, the relationship between MRC-ICU and the risk of fluid overload was examined. Patient demographics, fluid balance at day 3 of ICU admission, MRC-ICU score at 24 hours, and clinical outcomes were collected from the medical record. The primary outcome was relationship between MRC-ICU and fluid overload. To analyze this, MRC-ICU scores were divided into tertiles (low, moderate, high), and binary logistic regression was performed. Linear regression was performed to determine variables associated with positive fluid balance. RESULTS A total of 125 patients were included. The median MRC-ICU score at 24 hours of ICU admission for low, moderate, and high tertiles were 9, 15, and 21, respectively. For each point increase in MRC-ICU, a 13% increase in the likelihood of fluid overload was observed (OR 1.128, 95% CI 1.028-1.238, p = 0.011). The MRC-ICU score was positively associated with fluid balance at day 3 (β-coefficient 218.455, 95% CI 94.693-342.217, p = 0.001) when controlling for age, gender, and SOFA score. CONCLUSIONS Medication regimen complexity demonstrated a weakly positive correlation with fluid overload in critically ill patients. Future studies are necessary to establish the MRC-ICU as a predictor to identify patients at risk of fluid overload.
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Affiliation(s)
- William J Olney
- Department of Pharmacy, University of Kentucky Medical Center, Lexington, KY, USA
| | - Aaron M Chase
- Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Augusta, GA, USA
| | - Sarah A Hannah
- Department of Clinical and Administrative Pharmacy, University of Georgia, College of Pharmacy, Athens, GA, USA
| | - Susan E Smith
- Department of Clinical and Administrative Pharmacy, University of Georgia, College of Pharmacy, Athens, GA, USA
- Department of Pharmacy, Piedmont Athens Regional Medical Center, Athens, GA, USA
| | - Andrea Sikora Newsome
- Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Augusta, GA, USA
- Department of Pharmacy, Augusta University Medical Center, Augusta, GA, USA
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2
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Sayın Z, Sancar M, Özen Y, Okuyan B. Polypharmacy, potentially inappropriate prescribing and medication complexity in Turkish older patients in the community pharmacy setting. Acta Clin Belg 2022; 77:273-279. [PMID: 33031002 DOI: 10.1080/17843286.2020.1829251] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE This study aimed to evaluate polypharmacy, potentially inappropriate prescribing (PIP) and medication complexity in Turkish older patients in the community pharmacy setting and to determine the factors associated with PIP. METHODS This descriptive cross-sectional study was conducted in the community pharmacy setting in Istanbul. Older patients (≥65 years old) who chronically used at least one medication and visited the community pharmacy for any reason in the past 4 months were invited in this study. PIP was determined by using the Ghent Older People's Prescriptions Community Pharmacy Screening (GheOP3S)-tool. The Turkish version of the Medication Regimen Complexity Index (MRCI) was used to determine medication complexity. RESULTS Polypharmacy (defined as the concurrent use of five or more medications) was found in 69.0% of 158 patients. A total of 398 PIPs were detected and 83.5% (n = 132) of older patients had at least one PIP. The median (IQR) MRCI score was 12.5 (7.0-19.6). The factors associated with having ≥2 PIP were advanced age (≥75 years old) (OR = 2.87, 95% CI 1.41-5.81; p < 0.05), higher number of chronic diseases (when ≥3, OR = 8.51, 95% CI 3.66-19.76; p < 0.05), receiving polypharmacy (OR = 8.92, 95% CI 4.09-19.46; p < 0.05), and higher MRCI scores (when MRCI ≥12.5, OR = 4.40, 95% CI 2.22-8.71; p < 0.05). CONCLUSION More than half of the Turkish older patients had polypharmacy and the rate of PIP was high. A higher number of PIP was associated with advanced age, higher number of chronic diseases, polypharmacy, and more complex medication regimens.
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Affiliation(s)
- Zeynep Sayın
- Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, Istanbul, Turkey
| | - Mesut Sancar
- Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, Istanbul, Turkey
| | - Yasin Özen
- Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, Istanbul, Turkey
| | - Betul Okuyan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, Istanbul, Turkey
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Hayward KL, Valery PC, Patel PJ, Li C, Horsfall LU, Wright PL, Tallis CJ, Stuart KA, David M, Irvine KM, Cottrell N, Martin JH, Powell EE. Medication Discrepancies and Regimen Complexity in Decompensated Cirrhosis: Implications for Medication Safety. Pharmaceuticals (Basel) 2021; 14:1207. [PMID: 34959611 DOI: 10.3390/ph14121207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 11/17/2022] Open
Abstract
Discrepancies between the medicines consumed by patients and those documented in the medical record can affect medication safety. We aimed to characterize medication discrepancies and medication regimen complexity over time in a cohort of outpatients with decompensated cirrhosis, and evaluate the impact of pharmacist-led intervention on discrepancies and patient outcomes. In a randomized-controlled trial (n = 57 intervention and n = 57 usual care participants), medication reconciliation and patient-oriented education delivered over a six-month period was associated with a 45% reduction in the incidence rate of 'high' risk discrepancies (IRR = 0.55, 95%CI = 0.31-0.96) compared to usual care. For each additional 'high' risk discrepancy at baseline, the odds of having ≥ 1 unplanned medication-related admission during a 12-month follow-up period increased by 25% (adj-OR = 1.25, 95%CI = 0.97-1.63) independently of the Child-Pugh score and a history of variceal bleeding. Among participants with complete follow-up, intervention patients were 3-fold less likely to have an unplanned medication-related admission (adj-OR = 0.27, 95%CI = 0.07-0.97) compared to usual care. There was no association between medication discrepancies and mortality. Medication regimen complexity, frequent changes to the regimen and hepatic encephalopathy were associated with discrepancies. Medication reconciliation may improve medication safety by facilitating communication between patients and clinicians about 'current' therapies and identifying potentially inappropriate medicines that may lead to harm.
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Akhtar A, Ahmad Hassali MA, Zainal H, Ali I, Khan AH. A Cross-Sectional Assessment of Urinary Tract Infections Among Geriatric Patients: Prevalence, Medication Regimen Complexity, and Factors Associated With Treatment Outcomes. Front Public Health 2021; 9:657199. [PMID: 34733812 PMCID: PMC8558341 DOI: 10.3389/fpubh.2021.657199] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 09/06/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Urinary tract infections (UTIs) are the second most prevalent infection among the elderly population. Hence, the current study aimed to evaluate the prevalence of UTIs among older adults, medication regimen complexity, and the factors associated with the treatment outcomes of elderly patients infected with UTIs. Methods: A retrospective cross-sectional study was conducted at the Department of Urology, Hospital Pulau Pinang, Malaysia. The patients ≥65 years of age were included in the present study with a confirmed diagnosis of UTIs from 2014 to 2018 (5 years). Results: A total of 460 patients met the inclusion criteria and were included in the present study. Cystitis (37.6%) was the most prevalent UTI among the study population followed by asymptomatic bacteriuria (ASB) (31.9%), pyelonephritis (13.9%), urosepsis (10.2%), and prostatitis (6.4%). Unasyn (ampicillin and sulbactam) was used to treat the UTIs followed by Bactrim (trimethoprim/sulfamethoxazole), and ciprofloxacin. The factors associated with the treatment outcomes of UTIs were gender (odd ratio [OR] = 1.628; p = 0.018), polypharmacy (OR = 0.647; p = 0.033), and presence of other comorbidities (OR = 2.004; p = 0.002) among the study population. Conclusion: Cystitis is the most common UTI observed in older adults. Gender, the burden of polypharmacy, and the presence of comorbidities are the factors that directly affect the treatment outcomes of UTIs among the study population.
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Affiliation(s)
- Ali Akhtar
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, George Town, Malaysia
| | - Mohamed Azmi Ahmad Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, George Town, Malaysia
| | - Hadzliana Zainal
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, George Town, Malaysia
| | - Irfhan Ali
- Hospital Pulau Pinang, Ministry of Health, George Town, Malaysia
| | - Amer Hayat Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, George Town, Malaysia
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Olney WJ, Chase AM, Hannah SA, Smith SE, Newsome AS. Medication Regimen Complexity Score as an Indicator of Fluid Balance in Critically Ill Patients. J Pharm Pract 2021; 35:573-579. [PMID: 33685269 PMCID: PMC8426415 DOI: 10.1177/0897190021999792] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Critically ill patients are at increased risk for fluid overload, but objective prediction tools to guide clinical decision-making are lacking. The MRC-ICU scoring tool is an objective tool for measuring medication regimen complexity. OBJECTIVE To evaluate the relationship between MRC-ICU score and fluid overload in critically ill patients. METHODS In this multi-center, retrospective, observational study, the relationship between MRC-ICU and the risk of fluid overload was examined. Patient demographics, fluid balance at day 3 of ICU admission, MRC-ICU score at 24 hours, and clinical outcomes were collected from the medical record. The primary outcome was relationship between MRC-ICU and fluid overload. To analyze this, MRC-ICU scores were divided into tertiles (low, moderate, high), and binary logistic regression was performed. Linear regression was performed to determine variables associated with positive fluid balance. RESULTS A total of 125 patients were included. The median MRC-ICU score at 24 hours of ICU admission for low, moderate, and high tertiles were 9, 15, and 21, respectively. For each point increase in MRC-ICU, a 13% increase in the likelihood of fluid overload was observed (OR 1.128, 95% CI 1.028-1.238, p = 0.011). The MRC-ICU score was positively associated with fluid balance at day 3 (β-coefficient 218.455, 95% CI 94.693-342.217, p = 0.001) when controlling for age, gender, and SOFA score. CONCLUSIONS Medication regimen complexity demonstrated a weakly positive correlation with fluid overload in critically ill patients. Future studies are necessary to establish the MRC-ICU as a predictor to identify patients at risk of fluid overload.
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Affiliation(s)
- William J Olney
- Department of Pharmacy, University of Kentucky Medical Center, Lexington, KY, USA
| | - Aaron M Chase
- Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Augusta, GA, USA
| | - Sarah A Hannah
- Department of Clinical and Administrative Pharmacy, University of Georgia, College of Pharmacy, Athens, GA, USA
| | - Susan E Smith
- Department of Clinical and Administrative Pharmacy, University of Georgia, College of Pharmacy, Athens, GA, USA.,Department of Pharmacy, Piedmont Athens Regional Medical Center, Athens, GA, USA
| | - Andrea Sikora Newsome
- Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Augusta, GA, USA.,Department of Pharmacy, Augusta University Medical Center, Augusta, GA, USA
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Foubert K, Mehuys E, Claes L, Van Den Abeele D, Haems M, Somers A, Petrovic M, Boussery K. A shared medication scheme for community dwelling older patients with polypharmacy receiving home health care: role of the community pharmacist. Acta Clin Belg 2019; 74:326-333. [PMID: 30235081 DOI: 10.1080/17843286.2018.1521903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background and objective: An accurate medication scheme may be a useful tool to improve medication safety in primary care. This study aimed to identify (1) pharmacists' alterations to nurse medication schemes and (2) potential improvements to the contribution of the community pharmacist to a shared medication scheme within a multidisciplinary collaboration. Dosing frequency, potentially incorrect moments of intake, drug-drug interactions and medication complexity (quantified by the Medication Regimen Complexity Index, MRCI) were investigated. Setting and method: Observational study in community dwelling older patients (≥70 years) with polypharmacy receiving home health care (i.e. medications being prepared and/or administered by home care nurses). Home care nurses provided the community pharmacist with the original medication scheme ('nurse medication scheme'), subsequently the community pharmacist generated a standardized 'pharmacist medication scheme' which was uploaded on an electronic health platform (Vitalink). The researcher recorded all pharmacists' alterations and looked for possible additional improvements ('researcher medication scheme'). Results: Pharmacists made 482 alterations to the nurse medication schemes of 31 patients. Most important alterations included adding indication (61%), generic or brand name (18%) and moment of intake (9%). Pharmacists did not reduce dosing frequency. MRCI scores (median [IQR]) significantly differed between pharmacist (38 [15]) and nurse medication schemes (32 [11]) (p < 0.001) and between nurse (32 [11]) and researcher medication schemes (40 [15]) (p < 0.001). Conclusion: Alterations made by the community pharmacists enable more complete and accurate medication schemes; however, there is room for improvement in optimizing the patient's medication scheme in a multidisciplinary collaboration.
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Affiliation(s)
- Katrien Foubert
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Els Mehuys
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Leen Claes
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Dirk Van Den Abeele
- Royal Pharmacists Association of East Flanders (KOVAG), Sint-Martens-Latem, Belgium
| | - Marleen Haems
- Royal Pharmacists Association of East Flanders (KOVAG), Sint-Martens-Latem, Belgium
| | - Annemie Somers
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
- Department of Pharmacy, Ghent University Hospital, Ghent, Belgium
| | - Mirko Petrovic
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Koen Boussery
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
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Cobretti MR, Page RL, Linnebur SA, Deininger KM, Ambardekar AV, Lindenfeld J, Aquilante CL. Medication regimen complexity in ambulatory older adults with heart failure. Clin Interv Aging 2017; 12:679-686. [PMID: 28442898 PMCID: PMC5396835 DOI: 10.2147/cia.s130832] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Heart failure prevalence is increasing in older adults, and polypharmacy is a major problem in this population. We compared medication regimen complexity using the validated patient-level Medication Regimen Complexity Index (pMRCI) tool in "young-old" (60-74 years) versus "old-old" (75-89 years) patients with heart failure. We also compared pMRCI between patients with ischemic cardiomyopathy (ISCM) versus nonischemic cardiomyopathy (NISCM). PATIENTS AND METHODS Medication lists were retrospectively abstracted from the electronic medical records of ambulatory patients aged 60-89 years with heart failure. Medications were categorized into three types - heart failure prescription medications, other prescription medications, and over-the-counter (OTC) medications - and scored using the pMRCI tool. RESULTS The study evaluated 145 patients (n=80 young-old, n=65 old-old, n=85 ISCM, n=60 NISCM, mean age 73±7 years, 64% men, 81% Caucasian). Mean total pMRCI scores (32.1±14.4, range 3-84) and total medication counts (13.3±4.8, range 2-30) were high for the entire cohort, of which 72% of patients were taking eleven or more total medications. Total and subtype pMRCI scores and medication counts did not differ significantly between the young-old and old-old groups, with the exception of OTC medication pMRCI score (6.2±4 young-old versus 7.8±5.8 old-old, P=0.04). With regard to heart failure etiology, total pMRCI scores and medication counts were significantly higher in patients with ISCM versus NISCM (pMRCI score 34.5±15.2 versus 28.8±12.7, P=0.009; medication count 14.1±4.9 versus 12.2±4.5, P=0.008), which was largely driven by other prescription medications. CONCLUSION Medication regimen complexity is high in older adults with heart failure, and differs based on heart failure etiology. Additional work is needed to address polypharmacy and to determine if medication regimen complexity influences adherence and clinical outcomes in this population.
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Affiliation(s)
| | - Robert L Page
- Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO
| | - Sunny A Linnebur
- Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO
| | | | - Amrut V Ambardekar
- Division of Cardiology, School of Medicine, University of Colorado, Aurora, CO
| | - JoAnn Lindenfeld
- Advanced Heart Failure and Cardiac Transplant Program, Vanderbilt Heart and Vascular Institute, Nashville, TN, USA
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8
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Okuyan B, Babi B, Sancar M, Ay P, Yücel E, Yücel A, Izzettin FV. Validation of the Turkish version of medication regimen complexity index among elderly patients. J Eval Clin Pract 2016; 22:732-6. [PMID: 26987572 DOI: 10.1111/jep.12526] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 02/01/2016] [Accepted: 02/01/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The aim of this study was to validate the Turkish version of the 'Medication Regimen Complexity Index' (MRCI). METHODS This validation study has been conducted in prescriptions of the first 100 elderly patients who had visited the pharmacy for their prescription refill to evaluate convergent and divergent validity of the Turkish version. The reliability of the Turkish version was assessed with inter-rater and test-retest analysis after its translation and cultural adaptation. RESULTS The mean age of the 100 patients (53 women) was 74.9 years (SD = 7.58, 65-95). The scale showed high inter-rater reliability and test-retest reliability for the total and subscale scores (p < 0.05). A strong and positive correlation between the number of medications in a prescription and the total Medication Regimen Complexity Index scores (r = 0.930, p < 0.001) was determined. There were no statistically significant differences between age, gender and MRCI scores (p > 0.05). CONCLUSION These results show that the Turkish version of MRCI is a reliable and valid tool in elderly patients.
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Affiliation(s)
- Betul Okuyan
- Clinical Pharmacy Department, Marmara University, Faculty of Pharmacy, Istanbul, Turkey.
| | - Bedis Babi
- Clinical Pharmacy Department, Marmara University, Faculty of Pharmacy, Istanbul, Turkey
| | - Mesut Sancar
- Clinical Pharmacy Department, Marmara University, Faculty of Pharmacy, Istanbul, Turkey
| | - Pınar Ay
- Department of Public Health, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Emre Yücel
- Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, Houston, TX, USA
| | - Aylin Yücel
- Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, USA
| | - Fikret Vehbi Izzettin
- Clinical Pharmacy Department, Marmara University, Faculty of Pharmacy, Istanbul, Turkey
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Hong SH, Al-Ruthia Y, Tak S. Medication complexity and affordability in use of time release antidepressants. Clin Transl Sci 2014; 7:376-83. [PMID: 24898693 PMCID: PMC5350880 DOI: 10.1111/cts.12174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2023] Open
Abstract
While time-release (TR) formulations reduce medication complexity, their increased costs may compromise medication affordability. This study examined how medication complexity and affordability affect the extent of access to TR formulations among adult patients with depression. Study subjects consisted of adults (≥ 24 years old) with reported diagnoses of depression from the 2010 Medical Expenditure Panel Survey (MEPS). Antidepressants that offer choices between TR vs. IR (immediate release) were selected. Factors related to medication complexity and affordability were identifi ed based on the Andersonfs model of health services utilization. A multivariate logistic regression was used to examine the study hypotheses while controlling for complex survey sampling in MEPS. A total of 625 working adults with depression had fi lled prescriptions with TR formulations about 60% of the time. Factors related to medication affordability and complexity were signifi cantly associated with the extent of access to TR antidepressant formulations. Identifi cation of those factors associated with the use of TR formulations would contribute to improving access as well as adherence to antidepressant drug therapy.
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Affiliation(s)
- Song H Hong
- Department of Clinical Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Travis SS, McAuley WJ, Dmochowski J, Bernard MA, Kao HFS, Greene R. Factors associated with medication hassles experienced by family caregivers of older adults. Patient Educ Couns 2007; 66:51-7. [PMID: 17118616 PMCID: PMC1876685 DOI: 10.1016/j.pec.2006.10.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2006] [Revised: 10/04/2006] [Accepted: 10/07/2006] [Indexed: 05/12/2023]
Abstract
OBJECTIVE We wished to identify potential factors associated with medication administration hassles, daily irritants, among informal caregivers who provide long-term medication assistance to persons aged 55 or older. METHODS A sample of 156 informal caregivers were recruited from seven states and several types of settings. The dependent variable was scores on the Family Caregiver Medication Administration Hassles Scale (FCMAHS). Independent variables included in the analyses were medication complexity; caregiver's gender, ethnicity, relationship to recipient, length of time in caregiving, education, and employment outside the home; care recipient's physical capacity and mental capacity; and whether the caregiver and care recipient live together. After preliminary analysis to reduce the number of independent variables, the remaining variables were included in a linear model (GLM procedure). Possible interactions and residuals were considered. RESULTS Whites and Hispanics experience greater medication administration hassles than other groups, and perceived hassle intensity increases with medication complexity. Medication administration hassle scores increase with increasing education levels up to a high school degree, after which they remain consistently high. Caregivers whose care recipients have moderate levels of cognitive functioning have higher medication administration hassles scores than those whose care recipients have very high or very low cognitive functioning. CONCLUSION The preliminary set of significant variables can be used to identify caregivers who may be at risk of experiencing medication administration hassles, increased stress, and potentially harmful events for their care recipients. PRACTICE IMPLICATIONS Family caregivers are accepting complex caregiving responsibility for family members while receiving little or no support or assistance with caregiving hassles associated with this duty. The FCMAHS offers the means to monitor how caregivers are handling the daily irritants involved with medication administration so that educational interventions can be provided before hassles lead to more serious stress and strain.
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Affiliation(s)
- Shirley S Travis
- College of Health and Human Services, MS-2G7, George Mason University, 4400 University Drive, Fairfax, VA 22030-4444, United States.
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