Abstract

EVALUATION OF MEDICATION COMPLEXITY AND ITS ASSOCIATION WITH PRESCRIPTION RELATED PROBLEMS IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN A TERTIARY CARE HOSPITAL: A CROSS-SECTIONAL STUDY

Milan Thapa*, Upasana Acharya, Amish Uprety and Nabin Simkhada

Abstract

Introduction: COPD is the most common disease around the world. The main cause of the high rates of death, morbidity, and financial and societal burden associated with COPD is the necessity for extensive and ongoing medical care. One of the main strategies used to manage COPD is pharmacotherapy. Multiple medications are frequently prescribed to patients with COPD to manage their respiratory condition as well as related conditions. Complexity in the medication regimen leads to mistakes in administration and unintentional non-adherence, errors, adverse drug reactions (ADRs), and drug-drug interactions (DDIs) which have been linked to known consequences like increased expenses, hospital admissions, and mortality. Methods: An observational, cross-sectional study was conducted in general medicine ward of Dhulikhel Hospital to evaluate the Medication complexity using the validated Medication Regimen Complexity Index (MRCI) tool. Disease severity was assessed using CAT score. Potential drug-drug interactions and polypharmacy were assessed. After the assessment, an analysis was conducted to determine the association between these variables and the Medication Regimen Complexity Index. Results: In this study, 91 COPD prescriptions were evaluated. The mean age among the study population was 70.35 (± 9.9) years with the higher prevalence of women (63.7%). The patients were hospitalized for an average of 4.34 ± 1.85 days. Each prescription had an average of 6.42± 1.87 drugs. Polypharmacy was found in 87.91% of the prescriptions while potential drug- drug interactions were found in 14.28% of prescriptions. There was a minimum of 10 and a maximum of 38.5 for the complexity of medications, with a mean of 25.81 (± 4.61). A mean of 15.01 (±3.25) for dose frequency indicated the highest degrees of complexity, followed by an average of 9.91 (±1.66) for dosage forms and an average of 0.87 (±0.85) for additional instructions for use. A statistically significant association was found between the MRCI and both polypharmacy and drug-drug interaction. Conclusion: The study concluded that there are significant differences in medication complexity depending on whether polypharmacy and drug-drug interactions are present or not. When medication complexity rises, the likelihood of polypharmacy and drug-drug interactions will also rise.

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