Development and assessment of an abbreviated medication regimen complexity index (the A-MRCI).

IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY American Journal of Health-System Pharmacy Pub Date : 2025-01-24 DOI:10.1093/ajhp/zxae208
Rebekah P Scrivens, Ina Liu, Joshua D Niznik, Evan W Colmenares, Mary-Haston Vest, Jennifer Jacobson, Zachariah M Deyo
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Abstract

Purpose: Adaptation of the Medication Regimen Complexity Index (MRCI) for automation in an electronic medical record has the potential to improve medication optimization and patient outcomes. The purpose of this study was to develop and evaluate an abbreviated medication regimen complexity index (A-MRCI) and compare its associations with patient-level factors to those of the MRCI.

Methods: The MRCI was modified via several rounds of review with an expert panel of clinical pharmacists and outcomes researchers. Medication data from 138 electronic health records were abstracted to calculate MRCI and A-MRCI scores for dosage form, dosing frequency, and additional directions. Comparison between indices was performed using inferential statistics for a 1-month sample of patients admitted to a cardiology or advanced heart failure service in 2017.

Results: A-MRCI scores were higher than MRCI scores (mean difference of 3.97, P < 0.0005; 95% CI, 2.21-5.71). A significant association was observed between the A-MRCI score and both length of stay (P = 0.0005) and polypharmacy (P < 0.0005), whereas an association between MRCI score and the patient-level factors examined was not demonstrated.

Conclusion: On average, A-MRCI scores were higher and more likely to be associated with several patient-level factors. Internal analyses show the potential for integration into an electronic health record for automation. However, further exploration of the A-MRCI in a larger external validation sample is warranted.

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开发和评估简略用药方案复杂性指数(A-MRCI)。
免责声明:为了加快文章的出版速度,AJHP在接受稿件后会尽快在网上发布。被录用的稿件已经过同行评审和校对,但在进行技术格式化和作者校对之前会在网上发布。这些稿件并非最终记录版本,稍后将以最终文章(按AJHP风格排版并由作者校对)取代。目的:调整用药方案复杂性指数(MRCI),使其在电子病历中实现自动化,有可能改善用药优化和患者预后。本研究旨在开发和评估简略用药方案复杂性指数(A-MRCI),并将其与患者层面因素的关联与 MRCI 的关联进行比较:由临床药剂师和结果研究人员组成的专家小组经过多轮审查,对 MRCI 进行了修改。摘录了 138 份电子健康记录中的用药数据,以计算 MRCI 和 A-MRCI 在剂型、用药频率和附加说明方面的得分。对2017年心脏科或高级心力衰竭服务机构收治的为期1个月的患者样本,采用推断统计法进行指数间比较:A-MRCI评分高于MRCI评分(平均差异为3.97,P<0.0005;95% CI,2.21-5.71)。A-MRCI评分与住院时间(P = 0.0005)和多药治疗(P < 0.0005)之间存在明显关联,而MRCI评分与患者层面因素之间没有关联:结论:平均而言,A-MRCI评分更高,且更有可能与多个患者层面的因素相关。内部分析表明,A-MRCI 有可能整合到电子健康记录中,实现自动化。不过,有必要在更大的外部验证样本中进一步探索A-MRCI。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
18.50%
发文量
341
审稿时长
3-8 weeks
期刊介绍: The American Journal of Health-System Pharmacy (AJHP) is the official publication of the American Society of Health-System Pharmacists (ASHP). It publishes peer-reviewed scientific papers on contemporary drug therapy and pharmacy practice innovations in hospitals and health systems. With a circulation of more than 43,000, AJHP is the most widely recognized and respected clinical pharmacy journal in the world.
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