Journal article
Use of medication regimen complexity to target services in the community
Journal of the American Pharmacists Association, Vol.62(3), pp.750-756
05/01/2022
DOI: 10.1016/j.japh.2021.12.011
PMID: 35090814
Abstract
Background: In the community, successful medication therapy depends on patients managing complex medication regimens. To assist, pharmacists can sort patients on the basis of their regimen complexity and then tailor care appropriately.
Objectives: Objectives were to (1) develop a medication regimen complexity score and assess its reliability and validity, (2) design and implement a Less Complex program to tailor medication management services to the complexity of medication regimens, and (3) evaluate the impact that a Less Complex program had on identification and resolution of medication related problems (MRPs).
Methods: Patients in the Less Complex program were stratified into complexity categories on the basis of Iowa Medication Complexity Scores (IMECSs) to receive pharmacy services tailored to their complexity category. Types and numbers of MRPs identified and associated pharmacist interventions were extracted. Frequencies and descriptive statistics were calculated. To assess the reliability and validity of the IMECS, a stratified random sample of 125 patients was drawn. For each of these patients, baseline and end of 9-month scores for IMECS were compared with Medication Regimen Complexity Index (MRCI) scores using paired t tests.
Results: A total of 661 patients had both baseline and post-IMECSs. The mean IMECS for the sample of 661 patients decreased from 28.6 at baseline to 27.3 during the postperiod. For the stratified sample (n = 113), the MRCI showed a nonsignificant change from baseline to the end of treatment period, whereas the IMECS showed a statistically significant decrease from baseline to the end of treatment period. A total of 10,535 MRPs and 10,482 interventions were documented during the 9-month treatment period for 1019 patients.
Conclusion: Evidence supported initial reliability and validity of the IMECS. The Less Complex program identified and addressed many MRPs by matching patient complexity to service type. Future work is needed to evaluate a similar approach in other pharmacies. (C) 2022 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.
Details
- Title: Subtitle
- Use of medication regimen complexity to target services in the community
- Creators
- Randal P. McDonough - Towncrest Pharmacy, Iowa City, IA 52245Aaron McDonough - American Pharmacists AssociationWilliam R. Doucette - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of the American Pharmacists Association, Vol.62(3), pp.750-756
- Publisher
- Elsevier
- DOI
- 10.1016/j.japh.2021.12.011
- PMID
- 35090814
- ISSN
- 1544-3191
- eISSN
- 1544-3450
- Number of pages
- 7
- Grant note
- Center for Health Care Strategies, Inc, in Hamilton, NJ
- Language
- English
- Date published
- 05/01/2022
- Academic Unit
- Pharmacy Practice and Science
- Record Identifier
- 9984366042202771
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