A Carmine Colavecchia1, David R Putney2, Michael L Johnson3, Rajender R Aparasu4. 1. Houston Methodist Hospital, Department of Pharmacy, 6565 Fannin St., DB1-09, Houston, TX 77030, United States. Electronic address: accolavecchia@houstonmethodist.org. 2. Houston Methodist Hospital, Department of Pharmacy, 6565 Fannin St., DB1-09, Houston, TX 77030, United States. Electronic address: dputney@houstonmethodist.org. 3. University of Houston, Department of Pharmaceutical Health Outcomes and Policy, Texas Medical Center Campus, Room 326, 1441 Moursund Street, Houston, TX 77030, United States. Electronic address: mikejohnson@uh.edu. 4. University of Houston, Department of Pharmaceutical Health Outcomes and Policy, Texas Medical Center Campus, Room 425, 1441 Moursund Street, Houston, TX 77030, United States. Electronic address: rraparasu@uh.edu.
Abstract
BACKGROUND: Limited research exists regarding Medication Regimen Complexity Index (MRCI) and its utility in identifying patients at risk for hospital readmission. OBJECTIVE: This study evaluates the association between discharge MRCI and 30-day rehospitalization in patients with heart failure (HF) after discharge. METHODS: The study involved a retrospective, cohort study at a large tertiary teaching facility from the University HealthSystem Consortium. The consortium database was used to identify HF patients hospitalized from January 2011 to December 2013. A 30-day readmission was defined as being readmitted to the same hospital within 30 days of discharge with a principal discharge diagnosis of HF. Index hospitalizations was defined as the first hospitalization, and readmission was the subsequent hospitalization for HF. A pilot analysis was conducted to compare manual MRCI collection tool and a computerized scoring MRCI system. Multivariable logistic regression was used to examine the association of computerized MRCI (≥15) and 30-day rehospitalization after controlling for other variables. RESULTS: A total of 1,452 patients were included in the study with 81 patients (5.9%) readmitted within 30 days of discharge. The manual and computerized MRCIs were correlated with an R of 0.74 and R2 of 0.55. The multivariate logistic regression analysis found computerized MRCI ≥15 (OR: 1.62; 95% CI: 1.01-2.59) was associated with 30-day rehospitalization after controlling for other factors. Patients prescribed angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers, were less likely (OR: 0.54; CI: 0.33-0.89) to be readmitted 30 days after discharge, and patients with coronary artery disease were more likely (OR: 1.76; CI: 1.03-3.00) to be readmitted 30 days after discharge. CONCLUSIONS: The computerized MRCI score was moderately correlated with manual MRCI score. A significant association was found between computerized MRCI and 30-day HF readmission. Such predictive tools may allow pharmacists to prioritize patient care and optimize patient outcomes through medication therapy management.
BACKGROUND: Limited research exists regarding Medication Regimen Complexity Index (MRCI) and its utility in identifying patients at risk for hospital readmission. OBJECTIVE: This study evaluates the association between discharge MRCI and 30-day rehospitalization in patients with heart failure (HF) after discharge. METHODS: The study involved a retrospective, cohort study at a large tertiary teaching facility from the University HealthSystem Consortium. The consortium database was used to identify HF patients hospitalized from January 2011 to December 2013. A 30-day readmission was defined as being readmitted to the same hospital within 30 days of discharge with a principal discharge diagnosis of HF. Index hospitalizations was defined as the first hospitalization, and readmission was the subsequent hospitalization for HF. A pilot analysis was conducted to compare manual MRCI collection tool and a computerized scoring MRCI system. Multivariable logistic regression was used to examine the association of computerized MRCI (≥15) and 30-day rehospitalization after controlling for other variables. RESULTS: A total of 1,452 patients were included in the study with 81 patients (5.9%) readmitted within 30 days of discharge. The manual and computerized MRCIs were correlated with an R of 0.74 and R2 of 0.55. The multivariate logistic regression analysis found computerized MRCI ≥15 (OR: 1.62; 95% CI: 1.01-2.59) was associated with 30-day rehospitalization after controlling for other factors. Patients prescribed angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers, were less likely (OR: 0.54; CI: 0.33-0.89) to be readmitted 30 days after discharge, and patients with coronary artery disease were more likely (OR: 1.76; CI: 1.03-3.00) to be readmitted 30 days after discharge. CONCLUSIONS: The computerized MRCI score was moderately correlated with manual MRCI score. A significant association was found between computerized MRCI and 30-day HF readmission. Such predictive tools may allow pharmacists to prioritize patient care and optimize patient outcomes through medication therapy management.
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: A E M J H Linkens; V Milosevic; P H M van der Kuy; V H Damen-Hendriks; C Mestres Gonzalvo; K P G M Hurkens Journal: Int J Clin Pharm Date: 2020-05-30
Authors: Mohammad A Al-Mamun; Jacob Strock; Yushuf Sharker; Khaled Shawwa; Rebecca Schmidt; Douglas Slain; Ankit Sakhuja; Todd N Brothers Journal: J Clin Med Date: 2022-08-11 Impact factor: 4.964
Authors: Joshua J Neumiller; Kenn B Daratha; Radica Z Alicic; Robert A Short; Haleigh M Miller; Liza Gregg; Brian J Gates; Cynthia F Corbett; Sterling M McPherson; Katherine R Tuttle Journal: J Renin Angiotensin Aldosterone Syst Date: 2020 Jul-Sep Impact factor: 1.636