Validation and standardization of the Brazilian version of the Medication Regimen Complexity Index for older adults in primary care

Pantuzza, Laís Ln; Ceccato, Maria das Graças Braga; Silveira, Micheline Rosa; Pinto, Isabela Vl; Reis, Adriano Max Moreira

doi:10.1111/ggi.13261

Cited by 26 publications

(24 citation statements)

References 28 publications

(107 reference statements)

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“…3 The discrepancy relative to the association detected in our study may be attributed to the different profile of the population investigated, since the elderly present with a more complex pharmacotherapy. Additionally, the definition of elevated complexity (pharmacotherapy complexity MRCI >16.5) standardized for the elderly in Brazil 16 was adopted, which allows a more appropriate classification.…”

Section: Discussionmentioning

confidence: 99%

“…Another strength of the study is the determination of the association between the visit to an emergency department and the complexity of the pharmacotherapy utilized the exact definition of high complexity (MRCI >16.5) established in the standardization of MRCI for elderly Brazilians. 16…”

Section: Discussionmentioning

confidence: 99%

“…3 A divergência em relação a associação detectada no nosso estudo pode ser atribuída ao perfil diferente da população investigada, pois os idosos apresentam farmacoterapia mais complexa. Além disso, foi adotada a definição de complexidade elevada (complexidade da farmacoterapia >16,5) normatizada para idosos do Brasil, 16 que permite classificação mais adequada.…”

Section: Discussionunclassified

“…15 The complexity of pharmacotherapy was stratified as high complexity, yes (MRCI >16.5), or no (MRCI ≤16.5), according to the MRCI standardization proposed for the elderly in Brazil. 16 Vulnerability was assessed by the instrument Vulnerable Elders Survey (VES-13), transculturally adapted to Brazil. 17 The diagnoses and medications of risk for readmission were identified using the definition by Taha et al 9…”

Section: Methodsmentioning

confidence: 99%

“…15 A complexidade da farmacoterapia foi estratificada em complexidade alta sim (valor do índice de complexidade da farmacoterapia − ICF >16,5) ou não (ICF ≤16,5), segundo normatização do MRCI proposta para idosos do Brasil. 16 A vulnerabilidade foi avaliada pelo instrumento Protocolo de Identificação do Idoso Vulnerável (VES-13) adaptado transculturalmente para o Brasil do The Vulnerable Elders Survey . 17 Os diagnósticos e os medicamentos de risco para reinternação foram identificados usando a definição de Taha et al 9…”

Section: Métodosunclassified

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Emergency department visits of older adults within 30 days of discharge: analysis from the pharmacotherapy perspective

Santos¹,

Dias²,

Reis³

2019

Einstein (São Paulo)

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Objective To analyze, from the pharmacotherapy perspective, the factors associated to visits of older adults to the emergency department within 30 days after discharge.Methods A cross-sectional study carried out in a general public hospital with older adults. Emergency department visit was defined as the stay of the older adult in this service for up to 24 hours. The complexity of drug therapy was determined using the Medication Regimen Complexity Index. Potentially inappropriate drugs for use in older adults were classified according to the American Geriatric Society/Beers criteria of 2015. The outcome investigated was the frequency of visits to the emergency department within 30 days of discharge. Multivariate logistic regression was performed to identify the factors associated with the emergency department visit.Results A total of 255 elderly in the study, and 67 (26.3%) visited emergency department within 30 days of discharge. Polypharmacy and potentially inappropriate medications for older adults did not present a statistically significant association. The diagnosis of heart failure and Medication Regimen Complexity Index >16.5 were positively associated with emergency department visits (OR=2.3; 95%CI: 1.04-4.94; p=0.048; and OR=2.1; 95%CI: 1.11-4.02; p=0.011), respectively. Furthermore, the diagnosis of diabetes mellitus and chronic kidney disease were protection factors for the outcome (OR=0.4; 95%CI: 0.20-0.73; p=0.004; and OR=0.3; 95%CI: 0.13-0.86; p=0.023).Conclusion The diagnosis of heart failure and Medication Regimen Complexity Index >16.5 were positively associated with the occurrence of an emergency department visit within 30 days of discharge.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%