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Effect of number of medications and complexity of regimens on medication adherence and blood pressure management in hospitalized patients with hypertension

INTRODUCTION: 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. Howeve...

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Autores principales: Wakai, Eri, Ikemura, Kenji, Kato, Chika, Okuda, Masahiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191947/
https://www.ncbi.nlm.nih.gov/pubmed/34111189
http://dx.doi.org/10.1371/journal.pone.0252944
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author Wakai, Eri
Ikemura, Kenji
Kato, Chika
Okuda, Masahiro
author_facet Wakai, Eri
Ikemura, Kenji
Kato, Chika
Okuda, Masahiro
author_sort Wakai, Eri
collection PubMed
description INTRODUCTION: 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. METHODS: 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 ≥140 mmHg or ≥ 90 mmHg. Medication regimen complexity was quantified using the medication regimen complexity index (MRCI) score. RESULTS: Among 1,057 patients, 164 and 893 patients were categorized into poor and good adherence groups, respectively. The multivariate analyses revealed that age ≥ 71 years and oral MRCI score ≥ 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 ≥ 19.5, regardless of the age. The rate of readmission was similar. CONCLUSION: 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.
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spelling pubmed-81919472021-06-10 Effect of number of medications and complexity of regimens on medication adherence and blood pressure management in hospitalized patients with hypertension Wakai, Eri Ikemura, Kenji Kato, Chika Okuda, Masahiro PLoS One Research Article INTRODUCTION: 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. METHODS: 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 ≥140 mmHg or ≥ 90 mmHg. Medication regimen complexity was quantified using the medication regimen complexity index (MRCI) score. RESULTS: Among 1,057 patients, 164 and 893 patients were categorized into poor and good adherence groups, respectively. The multivariate analyses revealed that age ≥ 71 years and oral MRCI score ≥ 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 ≥ 19.5, regardless of the age. The rate of readmission was similar. CONCLUSION: 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. Public Library of Science 2021-06-10 /pmc/articles/PMC8191947/ /pubmed/34111189 http://dx.doi.org/10.1371/journal.pone.0252944 Text en © 2021 Wakai et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Wakai, Eri
Ikemura, Kenji
Kato, Chika
Okuda, Masahiro
Effect of number of medications and complexity of regimens on medication adherence and blood pressure management in hospitalized patients with hypertension
title Effect of number of medications and complexity of regimens on medication adherence and blood pressure management in hospitalized patients with hypertension
title_full Effect of number of medications and complexity of regimens on medication adherence and blood pressure management in hospitalized patients with hypertension
title_fullStr Effect of number of medications and complexity of regimens on medication adherence and blood pressure management in hospitalized patients with hypertension
title_full_unstemmed Effect of number of medications and complexity of regimens on medication adherence and blood pressure management in hospitalized patients with hypertension
title_short Effect of number of medications and complexity of regimens on medication adherence and blood pressure management in hospitalized patients with hypertension
title_sort effect of number of medications and complexity of regimens on medication adherence and blood pressure management in hospitalized patients with hypertension
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191947/
https://www.ncbi.nlm.nih.gov/pubmed/34111189
http://dx.doi.org/10.1371/journal.pone.0252944
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