Complexity of Medication Regimen Prescribed on Hospital Discharge in Paediatric and Geriatric Patients with Psychiatric Disorder

Abstract

Background: Prescribing multiple medications to a patient increases the complexity of the treatment regimen and, thereby, the chances of noncompliance and adverse effects. The phase of discharge from the hospital is a critical period wherein the patient and/or the caretakers have to assume the responsibility of taking/providing the medications as directed by the physician. The objective of this study is to assess the complexity of medication regimen prescribed on hospital discharge to pediatric and geriatric patients with psychiatric disorders using the Medication Regimen Complexity Index (MRCI) instrument. Method: A descriptive, case record based study was conducted. The complexity of the hospital discharge prescriptions in pediatric and geriatric psychiatry patients was measured using the Medication Regimen Complexity Index instrument. Results: Of the 90 discharge prescriptions studied, 40 belonged to pediatric age group. The median number of drugs that each patient received was two in the pediatric group and five in the geriatric group (p<0.001). The median MRCI score was significantly higher in the geriatric group (15.5) compared to the pediatric group (7.5) (p<0.001). Gender difference was seen with significantly higher scores in geriatric men. Conclusion: While polypharmacy is of concern across all age groups, our study showed that the medication regimen complexity in significantly higher in the geriatric age group. Special attention is required in case of geriatric patients to simplify their medication regimen at the time of hospital discharge in order to ensure better compliance.Key words: Age, Gender, Medication regimen complexity, Polypharmacy, Psychotropics. Key messages: 1.Medication regimen complexity index is significantly higher in geriatric patients with psychiatric morbidity. 2.Gender difference is seen in the medication regimen complexity. 3.Prescriptions with the same number of drugs can have different medication regimen complexity scores. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Assessing the Population-Level Correlation of Medication Regimen Complexity and Adherence Indices Using Electronic Health Records and Insurance Claims

“…Second, there have been a handful of studies validating the medication-derived measures in pediatric patients, [62][63][64][65] although children's adherence to medication could be affected by more complex factors such as family trust and caregiver involvement. The correlation assessment should be validated and needs further investigation in the pediatric population.…”