BACKGROUND: Medication regimen complexity describes multiple characteristics of a patient's prescribed drug regimen. Heart transplant recipients must comply with a lifelong regimen that consists of numerous medications. However, a systematic assessment of medication regimen complexity over time has not been conducted in this, or any other, transplant population. OBJECTIVE: The objective of this study was to quantify patient-level medication regimen complexity over time following primary heart transplantation and heart retransplantation, using the validated patient-level Medication Regimen Complexity Index (pMRCI) tool. METHODS: Medication lists were reviewed at transplant discharge and years 1, 3, and 5 post-primary heart transplant, and at transplant discharge and years 1 and 3 post-heart retransplantation. Medications were categorized as transplant-specific, other prescription, and over-the-counter (OTC). RESULTS: In primary heart transplant recipients (n = 60), mean total medication count was 14.3 ± 3.4 at transplant discharge and did not change significantly over time ( P = 0.64). Transplant-specific medication count decreased significantly from discharge (2.9 ± 0.4) to year 5 (2.3 ± 0.6); P = 0.02. However, 32% of patients were taking 16 or more total medications at year 5 posttransplant. More than 70% of the pMRCI score was attributed to other prescription and OTC medications, which was largely driven by dosing frequency in this cohort. Medication complexity did not differ significantly between heart retransplant recipients (n = 11) and matched primary heart transplant controls (n = 22). CONCLUSION: Together, these data highlight the substantial medication burden after heart transplantation and reveal opportunities to address medication regimen complexity in this, and other, transplant populations.
BACKGROUND: Medication regimen complexity describes multiple characteristics of a patient's prescribed drug regimen. Heart transplant recipients must comply with a lifelong regimen that consists of numerous medications. However, a systematic assessment of medication regimen complexity over time has not been conducted in this, or any other, transplant population. OBJECTIVE: The objective of this study was to quantify patient-level medication regimen complexity over time following primary heart transplantation and heart retransplantation, using the validated patient-level Medication Regimen Complexity Index (pMRCI) tool. METHODS: Medication lists were reviewed at transplant discharge and years 1, 3, and 5 post-primary heart transplant, and at transplant discharge and years 1 and 3 post-heart retransplantation. Medications were categorized as transplant-specific, other prescription, and over-the-counter (OTC). RESULTS: In primary heart transplant recipients (n = 60), mean total medication count was 14.3 ± 3.4 at transplant discharge and did not change significantly over time ( P = 0.64). Transplant-specific medication count decreased significantly from discharge (2.9 ± 0.4) to year 5 (2.3 ± 0.6); P = 0.02. However, 32% of patients were taking 16 or more total medications at year 5 posttransplant. More than 70% of the pMRCI score was attributed to other prescription and OTC medications, which was largely driven by dosing frequency in this cohort. Medication complexity did not differ significantly between heart retransplant recipients (n = 11) and matched primary heart transplant controls (n = 22). CONCLUSION: Together, these data highlight the substantial medication burden after heart transplantation and reveal opportunities to address medication regimen complexity in this, and other, transplant populations.
Authors: Austin M Saderup; Mary Morrow; Anne M Libby; Ryan P Coyle; Stacey S Coleman; Jia-Hua Zheng; Lucas Ellison; Lane R Bushman; Jennifer J Kiser; Samantha MaWhinney; Peter L Anderson; Jose R Castillo-Mancilla Journal: Pharmacotherapy Date: 2021-01-09 Impact factor: 4.705
Authors: Michael R Cobretti; Robert L Page; Sunny A Linnebur; Kimberly M Deininger; Amrut V Ambardekar; JoAnn Lindenfeld; Christina L Aquilante Journal: Clin Interv Aging Date: 2017-04-12 Impact factor: 4.458
Authors: Justine Marienne; Solène M Laville; Pauline Caillard; Benjamin Batteux; Valérie Gras-Champel; Kamel Masmoudi; Gabriel Choukroun; Sophie Liabeuf Journal: Kidney Int Rep Date: 2020-10-17
Authors: Kelly L Hayward; Patricia C Valery; Preya J Patel; Catherine Li; Leigh U Horsfall; Penny L Wright; Caroline J Tallis; Katherine A Stuart; Michael David; Katharine M Irvine; Neil Cottrell; Jennifer H Martin; Elizabeth E Powell Journal: Pharmaceuticals (Basel) Date: 2021-11-23