Effect of number of medications and complexity of regimens on medication adherence and blood pressure management in hospitalized patients with hypertension
Good adherence of antihypertensives is recommended for the accomplishment of hypertension therapy. The number of medications and characteristics contributing to medication regimen complexity, such as dosage forms and dosing frequency, are known to influence medication adherence. However, the effect...
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| description | Good adherence of antihypertensives is recommended for the accomplishment of hypertension therapy. The number of medications and characteristics contributing to medication regimen complexity, such as dosage forms and dosing frequency, are known to influence medication adherence. However, the effect of medication regimen complexity on the therapeutic efficacy of medicines remains to be clarified. In the present study, we retrospectively investigated the effect of number of medications and medication regimen complexity on medication adherence and therapeutic efficacy in patients with hypertension. According to the inclusion and exclusion criteria, 1,057 patients, who were on medications including antihypertensives on admission at the Mie University Hospital between July 2018 and December 2018, were enrolled in this study. Poor blood pressure management was defined if the systolic or diastolic blood pressure were [greater than or equal to]140 mmHg or [greater than or equal to] 90 mmHg. Medication regimen complexity was quantified using the medication regimen complexity index (MRCI) score. Among 1,057 patients, 164 and 893 patients were categorized into poor and good adherence groups, respectively. The multivariate analyses revealed that age [greater than or equal to] 71 years and oral MRCI score [greater than or equal to] 19.5 but not number of oral medications were extracted as risk factors for poor medication adherence. Medication adherence and blood pressure management were poor in the group with oral MRCI score [greater than or equal to] 19.5, regardless of the age. The rate of readmission was similar. Our study is the first to demonstrate that medication regimen complexity rather than number of medications is closely related to medication adherence and blood pressure management. Hence, physicians and/or pharmacists should consider the complexity of medication regimens while modifying them. |
| doi_str_mv | 10.1371/journal.pone.0252944 |
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The number of medications and characteristics contributing to medication regimen complexity, such as dosage forms and dosing frequency, are known to influence medication adherence. However, the effect of medication regimen complexity on the therapeutic efficacy of medicines remains to be clarified. In the present study, we retrospectively investigated the effect of number of medications and medication regimen complexity on medication adherence and therapeutic efficacy in patients with hypertension. According to the inclusion and exclusion criteria, 1,057 patients, who were on medications including antihypertensives on admission at the Mie University Hospital between July 2018 and December 2018, were enrolled in this study. Poor blood pressure management was defined if the systolic or diastolic blood pressure were [greater than or equal to]140 mmHg or [greater than or equal to] 90 mmHg. Medication regimen complexity was quantified using the medication regimen complexity index (MRCI) score. Among 1,057 patients, 164 and 893 patients were categorized into poor and good adherence groups, respectively. The multivariate analyses revealed that age [greater than or equal to] 71 years and oral MRCI score [greater than or equal to] 19.5 but not number of oral medications were extracted as risk factors for poor medication adherence. Medication adherence and blood pressure management were poor in the group with oral MRCI score [greater than or equal to] 19.5, regardless of the age. The rate of readmission was similar. Our study is the first to demonstrate that medication regimen complexity rather than number of medications is closely related to medication adherence and blood pressure management. Hence, physicians and/or pharmacists should consider the complexity of medication regimens while modifying them.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0252944</identifier><identifier>PMID: 34111189</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Age ; Alcohol use ; Antihypertensives ; Blood pressure ; Cardiovascular diseases ; Care and treatment ; Cerebrovascular diseases ; Cognitive ability ; Complexity ; Complications ; Coronary artery disease ; Data analysis ; Disease ; Dosage ; Drug dosages ; Drug stores ; Drugs ; Editing ; Electronic health records ; Evaluation ; Graduate schools ; Graduate studies ; Health risks ; Heart diseases ; Heart failure ; Hospitals ; Hypertension ; Management ; Medical records ; Medication adherence ; Medicine and Health Sciences ; Methodology ; Multivariate analysis ; Oral administration ; Patient compliance ; Patients ; Pharmacology ; Pharmacy ; Risk analysis ; Risk factors ; Systematic review</subject><ispartof>PloS one, 2021-06, Vol.16 (6), p.e0252944-e0252944</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Wakai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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The number of medications and characteristics contributing to medication regimen complexity, such as dosage forms and dosing frequency, are known to influence medication adherence. However, the effect of medication regimen complexity on the therapeutic efficacy of medicines remains to be clarified. In the present study, we retrospectively investigated the effect of number of medications and medication regimen complexity on medication adherence and therapeutic efficacy in patients with hypertension. According to the inclusion and exclusion criteria, 1,057 patients, who were on medications including antihypertensives on admission at the Mie University Hospital between July 2018 and December 2018, were enrolled in this study. Poor blood pressure management was defined if the systolic or diastolic blood pressure were [greater than or equal to]140 mmHg or [greater than or equal to] 90 mmHg. Medication regimen complexity was quantified using the medication regimen complexity index (MRCI) score. Among 1,057 patients, 164 and 893 patients were categorized into poor and good adherence groups, respectively. The multivariate analyses revealed that age [greater than or equal to] 71 years and oral MRCI score [greater than or equal to] 19.5 but not number of oral medications were extracted as risk factors for poor medication adherence. Medication adherence and blood pressure management were poor in the group with oral MRCI score [greater than or equal to] 19.5, regardless of the age. The rate of readmission was similar. Our study is the first to demonstrate that medication regimen complexity rather than number of medications is closely related to medication adherence and blood pressure management. Hence, physicians and/or pharmacists should consider the complexity of medication regimens while modifying them.</description><subject>Age</subject><subject>Alcohol use</subject><subject>Antihypertensives</subject><subject>Blood pressure</subject><subject>Cardiovascular diseases</subject><subject>Care and treatment</subject><subject>Cerebrovascular diseases</subject><subject>Cognitive ability</subject><subject>Complexity</subject><subject>Complications</subject><subject>Coronary artery disease</subject><subject>Data analysis</subject><subject>Disease</subject><subject>Dosage</subject><subject>Drug dosages</subject><subject>Drug stores</subject><subject>Drugs</subject><subject>Editing</subject><subject>Electronic health records</subject><subject>Evaluation</subject><subject>Graduate schools</subject><subject>Graduate studies</subject><subject>Health risks</subject><subject>Heart diseases</subject><subject>Heart 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hypertension</atitle><jtitle>PloS one</jtitle><date>2021-06-10</date><risdate>2021</risdate><volume>16</volume><issue>6</issue><spage>e0252944</spage><epage>e0252944</epage><pages>e0252944-e0252944</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Good adherence of antihypertensives is recommended for the accomplishment of hypertension therapy. The number of medications and characteristics contributing to medication regimen complexity, such as dosage forms and dosing frequency, are known to influence medication adherence. However, the effect of medication regimen complexity on the therapeutic efficacy of medicines remains to be clarified. In the present study, we retrospectively investigated the effect of number of medications and medication regimen complexity on medication adherence and therapeutic efficacy in patients with hypertension. According to the inclusion and exclusion criteria, 1,057 patients, who were on medications including antihypertensives on admission at the Mie University Hospital between July 2018 and December 2018, were enrolled in this study. Poor blood pressure management was defined if the systolic or diastolic blood pressure were [greater than or equal to]140 mmHg or [greater than or equal to] 90 mmHg. Medication regimen complexity was quantified using the medication regimen complexity index (MRCI) score. Among 1,057 patients, 164 and 893 patients were categorized into poor and good adherence groups, respectively. The multivariate analyses revealed that age [greater than or equal to] 71 years and oral MRCI score [greater than or equal to] 19.5 but not number of oral medications were extracted as risk factors for poor medication adherence. Medication adherence and blood pressure management were poor in the group with oral MRCI score [greater than or equal to] 19.5, regardless of the age. The rate of readmission was similar. Our study is the first to demonstrate that medication regimen complexity rather than number of medications is closely related to medication adherence and blood pressure management. Hence, physicians and/or pharmacists should consider the complexity of medication regimens while modifying them.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34111189</pmid><doi>10.1371/journal.pone.0252944</doi><tpages>e0252944</tpages><orcidid>https://orcid.org/0000-0003-1870-9571</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Age Alcohol use Antihypertensives Blood pressure Cardiovascular diseases Care and treatment Cerebrovascular diseases Cognitive ability Complexity Complications Coronary artery disease Data analysis Disease Dosage Drug dosages Drug stores Drugs Editing Electronic health records Evaluation Graduate schools Graduate studies Health risks Heart diseases Heart failure Hospitals Hypertension Management Medical records Medication adherence Medicine and Health Sciences Methodology Multivariate analysis Oral administration Patient compliance Patients Pharmacology Pharmacy Risk analysis Risk factors Systematic review |
| title | Effect of number of medications and complexity of regimens on medication adherence and blood pressure management in hospitalized patients with hypertension |
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