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Factors associated with medication regimen complexity in older people: a cross-sectional population-based study

  • Pharmacoepidemiology and Prescription
  • Published:
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Abstract

Purpose

There is a lack of population-based research about factors associated with medication regimen complexity. This study investigated factors associated with medication regimen complexity in older people, and whether factors associated with regimen complexity were similar to factors associated with number of medications.

Methods

This cross-sectional population-based study included 3348 people aged ≥60 years. Medication regimen complexity was computed using the validated 65-item Medication Regimen Complexity Index (MRCI). Multinomial logistic regression was used to compute unadjusted and adjusted odds ratios (ORs) with 95 % confidence intervals (CIs) for factors associated with regimen complexity. Multivariable quantile regression was used to compare factors associated with regimen complexity and number of medications.

Results

In adjusted analyses, participants in the highest MRCI quintile (MRCI > 20) were older (OR = 1.04, 95 % CI 1.02;1.05), less likely to live at home (OR = 0.35, 95 % CI 0.15;0.86), had greater comorbidities (OR = 2.17, 95 % CI 1.89;2.49), had higher cognitive status (OR = 1.06, 95 % CI 1.01;1.11), a higher prevalence of self-reported pain (OR = 2.85, 95 % CI 2.16;3.76), had impaired dexterity (OR = 2.39, 95 % CI 1.77;3.24) and were more likely to receive help to sort their medications (OR = 4.43 95 % CI 2.39;8.56) than those with low regimen complexity (MRCI >0–5.5). Similar factors were associated with both regimen complexity and number of medications.

Conclusion

Older people with probable difficulties managing complex regimens, including those with impaired dexterity and living in institutional settings, had the most complex medication regimens even after adjusting for receipt of help to sort medications. The strong correlation between regimen complexity and number of medications suggests that clinicians could use a person’s number of medications to target interventions to reduce complexity.

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Acknowledgments

The Swedish National study on Aging and Care, SNAC, (www.snac.org) is financially supported by the Ministry of Health and Social Affairs, Sweden; the participating county councils and municipalities and the Swedish Research Council. We thank all participants and members of the SNAC-K Project Study Group. Our special thanks go to Associate Professor Ingemar Kåreholt and Dr Kris Jamsen for statistical support.

Conflict of interest

The authors declare no potential conflict of interest with respect to the research, authorship and/or publication of this article.

Authors’ contribution

BCW conceptualised the study, analysed the data and drafted the manuscript. JSB and KJ conceptualised the study and critically revised the manuscript for intellectual content. JF and MDW contributed to the design of the study and critically revised the manuscript for intellectual content. All authors approved the final manuscript submitted for publication.

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Authors and Affiliations

  1. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia

    Barbara Caecilia Wimmer & J. Simon Bell

  2. Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden

    Kristina Johnell & Johan Fastbom

  3. Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia

    Michael David Wiese & J. Simon Bell

Authors
  1. Barbara Caecilia Wimmer
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Correspondence to Barbara Caecilia Wimmer.

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Wimmer, B.C., Johnell, K., Fastbom, J. et al. Factors associated with medication regimen complexity in older people: a cross-sectional population-based study. Eur J Clin Pharmacol 71, 1099–1108 (2015). https://doi.org/10.1007/s00228-015-1883-2

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  • DOI: https://doi.org/10.1007/s00228-015-1883-2

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