Implications of the medication regimen complexity index score on hospital readmissions in elderly patients with heart failure: a retrospective cohort study

Abstract

Background The likelihood of elderly patients with heart failure (HF) being readmitted to the hospital is higher if they have a higher medication regimen complexity index (MRCI) compared to those with a lower MRCI. The objective of this study was to investigate whether there is a correlation between the MRCI score and the frequency of hospital readmissions (30-day, 90-day, and 1-year) among elderly patients with HF. Methods In this single-center retrospective cohort study, MRCI scores were calculated using a well-established tool. Patients were categorized into high (≥ 15) or low (< 15) MRCI score groups. The primary outcome examined the association between MRCI scores and 30-day hospital readmission rates. Secondary outcomes included the relationships between MRCI scores and 90-day readmission, one-year readmission, and mortality rates. Multivariate logistic regression was employed to assess the 30- and 90-day readmission rates, while Kaplan-Meier analysis was utilized to plot mortality. Results A total of 150 patients were included. The mean MRCI score for all patients was 33.43. 90% of patients had a high score. There was no link between a high MCRI score and a high 30-day readmission rate (OR 1.02; 95% CI 0.99–1.05; p < 0.13). A high MCRI score was associated with an initial significant increase in the 90-day readmission rate (odd ratio, 1.03; 95% CI, 1.00-1.07; p < 0.022), but not after adjusting for independent factors (odd ratio, 0.99; 95% CI, 0.95–1.03; p < 0.487). There was no significant difference between high and low MRCI scores in their one-year readmission rate. Conclusion The study’s results indicate that there is no correlation between a higher MRCI score and the rates of hospital readmission or mortality among elderly patients with HF. Therefore, it can be concluded that the medication regimen complexity index does not appear to be a significant predictor of hospital readmission or mortality in this population.

Validation and Assessment of Patients' and Their Caregivers' Attitude Toward Medications Deprescribing in Qatar: A Cross-sectional study of Home Health Care Services in Qatar

“…In this study, more than half of the patients and caregivers had felt that they were taking a large number of medications and they had also felt that it was a burden to them. This is also similar to the previously published studies indicating that polypharmacy is prevalent in Qatar and the region (15)(16)(17)(18)(19)(20). A considerable number of patients and caregivers felt that they were using or administering medications that were no longer needed.…”

“…In Qatar, the prevalence of polypharmacy in elderly patients was estimated to be 75%-88% (19,40), and potentially inappropriate medication use was 38%-75% (15,44), concluding a higher number of drugrelated problems in our elderly population (45). The increasing and cumulative evidence from Qatar and the Middle East about polypharmacy and its negative consequences among our elderly population is indicating and necessitating deprescribing.…”

“…Deprescribing is de ned as 'the process of withdrawal of an inappropriate medication, supervised by a health care professional, to manage polypharmacy and improve the clinical outcomes (14). Although the prevalence of polypharmacy and potentially inappropriate medications among the elderly population is considered high (15,16,17,18,19); deprescribing practices are very few, limited, and usually reactive in nature in response to adverse reactions or harm (20). Implementing deprescribing trials has been associated with improved clinical outcomes for the elderly population; reduced medications adverse drug reactions, improved adherence to prescribed medications (21)(22)(23)(24)(25), reduced healthcare costs (13,22,26), and enhanced patients' and caregivers' satisfaction (22,27,28) and reduced burdens of numerous medications administration (29,30).…”

Factors Associated with Hyperpolypharmacy and Complex Medication Regimens in Kidney Transplant Recipients

“…Higher medication complexity assessed by MRCI (but not polypharmacy) was associated with higher mortality in older people in some studies [12,13]. Another study of older patients with heart failure failed to identify medication complexity as a risk factor for rehospitalization or mortality [14].…”