Abstract
Medication regimen complexity (MRC) may influence health outcomes, such as hospitalisation, hospital readmission and medication adherence. Pharmacists have been referred to as health professionals with the opportunity to act on MRC reduction. This study aimed to investigate pharmacists’ role in studies about older adults’ medication regimen complexity. A literature search was performed in PubMed, Web of Science and the Cochrane Library—CENTRAL—up to October 2019. Out of 653 potentially relevant studies, 17 articles met the inclusion criteria for this review. Most studies used the 65-item medication regimen complexity index (MRCI) to assess medication complexity. Pharmacists’ role was mainly confined to data collection. It seems that pharmacists’ active role in older adults’ medication complexity has not been studied in depth so far. However, the few existing interventional ones suggest that, after previous training, regimen simplification is feasible.
Highlights
Active role in older adults’ medication complexity has not been studied in depth so far
Three recent systematic reviews focused on medication regimen complexity (MRC): Wimmer et al [20] reviewed the association of clinical outcomes with MRC in older people, Pantuzza et al [4] investigated the association between MRC and pharmacotherapy adherence and Alves-Conceição et al [47]
Several instruments were used in the different studies, including the medication complexity index (MCI) [31], which failed to show satisfactory reliability with complex regimens, and did not demonstrate any significant correlation with outcomes such as medication adherence [15,48]
Summary
Active role in older adults’ medication complexity has not been studied in depth so far. Several tools have been used, with the 65-item medication regimen complexity index (MRCI), developed by George et al [15], being the most common, reliable and validated tool for this purpose, which has already been translated and validated to a few languages [16,17,18] and even standardised for older adults in primary care [19]. It is an open-ended index, with higher total MRCI scores representing more complex medication regimens. Public Health 2021, 18, 8824 to the population’s medication, both in community pharmacies and hospital settings, and awareness of this topic is needed, especially in the older population, for whom managing their daily medication may often represent a considerable challenge
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