1251 Association of Medication Complexity with Patient Medication Experience

W. Doucette; E. Weyenberg; M. Said; R. McDonough; S. Hou

doi:10.1016/j.japh.2025.102715

Objectives This study examined the correlation between Iowa Medication Complexity Score (IMECS) and patient experiences with their medication therapy. IMECS, a measure of medication regimen complexity, has been used to match patient needs to service intensity. However, IMECS has not been studied to determine its association with patient-reported outcomes and experiences related to medication use. Better understanding of how IMECS relates to patient-reported data can advance its use for managing populations of community-based patients. The objective of this study was to examine the association of medication complexity with self-reported patient health indicators and medication-related experiences. Methods IMECS is a simple sum of five factors for a 180-day period: number of 1) unique medications dispensed, 2) prescribers, 3) dates on which medications were dispensed, 4) dosage forms, and 5) high-risk medications. IMECS has three complexity categories: low (1-24), medium (25-40), and high (>40). Working with one community pharmacy, two data sources were used: a patient survey and data extracted from respondents’ pharmacy records. The survey focused on multiple aspects of patients’ medication experience including medication adherence, symptoms and overall health score. Most of the questions used established measurements, including the Somatic Symptom Scale, the Adherence Estimator and the EQ-5D-5L questionnaire. The survey was mailed to a random sample of 600 patients aged 50 or older, with two reminders also mailed about 2 and 4 weeks after the initial mailing. Willing respondents consented to having their latest IMECS values and demographics extracted from their pharmacy patient records. Depending on the type of variable, means or percentages were compared across the three IMECS categories. Results While a total of 266 surveys were collected, these results are for the 198 respondents for whom both survey and IMECS data were available. Participants averaged 72.8 years old with 52.5 percent being female. Forty-eight (24%) patients fell into the low IMECS score (i.e. low complexity) category (mean=11.6), seventy-one (36%) into the medium category (mean=31.9), and seventy-nine (40%) into the high group (mean=54.5). The mean number of medications dispensed during the 180-day period for the respective IMECS categories were 3.1 (low), 8.8 (medium) and 17.1 (high). Scores on the symptom scale differed significantly across the IMECS categories, with patients in the high complexity category reporting the most symptoms [means: low=6.2, medium=5.9, high=8.7]. Similarly, the three groups differed significantly in percentage deemed low risk for nonadherence on the Adherence Estimator, with the high IMECS patients having the lowest percentage calculated as low risk of nonadherence [%: low=62.2, medium=72.1, high=53.8]. Using the EQ-5 data, high IMECS patients were found to have the lowest overall health status [means: low=80.4, medium=80.3, high=71.8] and poorer ratings on mobility [% with no problem: low=48.9, medium=62.0, high=38.0] and usual activities [% with no problem: low=61.7, medium=56.3, high=27.8] compared to the other two IMECS categories. Conclusions/Implications This study provides initial evidence that the IMECS is associated with patient-reported symptoms and health status variables. The IMECS, comprised of data readily available in community pharmacies, shows promise as a tool for sorting patients who may need greater service intensity for managing their health. Future research could be conducted to utilize IMECS in guiding the type and intensity of pharmacy services delivered to a population of community-based patients. As population health management more fully addresses medication therapy in the community, having tools such as IMECS is vital for guiding resource allocation to different patient groups.

1251 Association of Medication Complexity with Patient Medication Experience

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