Medication Regimen Complexity Index After Kidney Transplant in Fortaleza, Brazil

Abstract

Background: The Medication Regimen Complexity Index (MRCI) is a reliable tool to evaluate the complexity of pharmacotherapy and can predict the treatment adherence of post-transplant patients. The MRCI was evaluated in the post-kidney transplant period. Materials and Methods: In a descriptive, observational, and cross-sectional study, we evaluated the pharmacotherapy and the MRCI of kidney transplant patients for a year in a kidney transplant outpatient clinic at a university hospital in Fortaleza, Brazil. A convenience sample was obtained and analyzed the records of kidney transplant recipients who had at least two visits with pharmacists. The main outcome measures are characterization of immunosuppressive regimen, MRCI score, correlations between MRCI score and a period post-transplant. Results: 109 patients were included in the study. The predominant class was antineoplastic and immunomodulating agents (27.7%), and the most frequent immunosuppressive regimen was tacrolimus, mycophenolate sodium and prednisone (63.30%). The mean points in MRCI were 46; minimum of 19 points associated with 3 drugs and maximum of 83.5 points with 16. About sections A, B and C of the MRCI, the means found were 2.60, 13.2 and 30.6 points, respectively. Correlations between MRCI score and number of medications were checked, and a period less than 180 days after transplantation had score >40 points. Conclusion: MRCI in the kidney transplant patient is linked to the number of medications, dose and additional instructions. To improve adherence to the treatment, patient orientation is necessary especially in the first year after transplant.