Simplified medication regimen and survival in polypathological patients

Díez-Manglano, Jesús; Muñoz, Lorena Bellostas

doi:10.1016/j.medcle.2019.06.020

Cited by 3 publications

(2 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The total number of readmissions within 12 months was initially signi cantly higher in those with high MRCI and elevated Charlson comorbidity index and polypharmacy compared to those with low MRCI and it was more predominant among the Qatari population compared to other nationalities, but again this was non-signi cant after adjusting other variables. In our study, although the mortality rate was not statistically signi cantly higher in the high MRCI group, it may be of clinical signi cance, which may con rm the results of the previously published study that concluded higher survival rate in elderly patients with simpli ed regimen compared to those with complex regimen [33]. The previously published studies investigating MRCI had focused on elderly patients with multiple co-morbidities, polypharmacy, and subsequently higher medication regimen complexity [34,35].…”

Section: Discussionsupporting

confidence: 83%

Implications of the Medication Regimen Complexity Index Score on Hospital Readmissions in Elderly Patients with Heart Failure: A Retrospective Cohort Study

Abdelbary

Kaddoura

Balushi

et al. 2023

Preprint

View full text Add to dashboard Cite

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 The study was a retrospective cohort study conducted at a single center, in which MRCI scores were computed utilizing a published tool for 30 patients with high MRCI scores and 30 patients with low MRCI scores. Results A total of 150 patients were included. The mean MRCI score for all patients was 33.43. Ninety percent 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.

show abstract

Section: Discussionsupporting

confidence: 83%

Implications of the Medication Regimen Complexity Index Score on Hospital Readmissions in Elderly Patients with Heart Failure: A Retrospective Cohort Study

Abdelbary

Kaddoura

Balushi

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Previous findings show that MRCI is correlated with health outcomes, specifically prognosis (of diabetes and hepatocellular carcinoma) but also mortality [ 21 ]. Two different studies utilized registry data and hospital records to show that high MRCI scores were associated with higher 4-year mortality, and higher odds of mortality (adjusted odds ratio = 1.12) [ 22 , 23 ], respectively. A recent study showed that higher MRCI was associated with increased mortality, a longer ICU length of stay (LOS), and the need for mechanical ventilation (MV) [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Medication Regimen Complexity Index Score at Admission as a Predictor of Inpatient Outcomes: A Machine Learning Approach

Mbous

Brothers

Al-Mamun

2023

IJERPH

View full text Add to dashboard Cite

Background: In the intensive care unit, traditional scoring systems use illness severity and/or organ failure to determine prognosis, and this usually rests on the patient’s condition at admission. In spite of the importance of medication reconciliation, the usefulness of home medication histories as predictors of clinical outcomes remains unexplored. Methods: A retrospective cohort study was conducted using the medical records of 322 intensive care unit (ICU) patients. The predictors of interest included the medication regimen complexity index (MRCI) at admission, the Acute Physiology and Chronic Health Evaluation (APACHE) II, the Sequential Organ Failure Assessment (SOFA) score, or a combination thereof. Outcomes included mortality, length of stay, and the need for mechanical ventilation. Machine learning algorithms were used for outcome classification after correcting for class imbalances in the general population and across the racial continuum. Results: The home medication model could predict all clinical outcomes accurately 70% of the time. Among Whites, it improved to 80%, whereas among non-Whites it remained at 70%. The addition of SOFA and APACHE II yielded the best models among non-Whites and Whites, respectively. SHapley Additive exPlanations (SHAP) values showed that low MRCI scores were associated with reduced mortality and LOS, yet an increased need for mechanical ventilation. Conclusion: Home medication histories represent a viable addition to traditional predictors of health outcomes.

show abstract

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

et al. 2023

View full text Add to dashboard Cite

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.

show abstract

Simplified medication regimen and survival in polypathological patients

Cited by 3 publications

References 28 publications

Implications of the Medication Regimen Complexity Index Score on Hospital Readmissions in Elderly Patients with Heart Failure: A Retrospective Cohort Study

Implications of the Medication Regimen Complexity Index Score on Hospital Readmissions in Elderly Patients with Heart Failure: A Retrospective Cohort Study

Medication Regimen Complexity Index Score at Admission as a Predictor of Inpatient Outcomes: A Machine Learning Approach

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

Contact Info

Product

Resources

About