4CPS-069 Calculation of the therapeutic complexity of the institutionalised patient in a tertiary hospital

<h3>Background and Importance</h3> Therapeutic complexity is directly related to treatment adherence, with studies indicating that 50% of patients do not follow their medication regimen. Increased complexity is associated with higher rates of hospital admissions, reduced quality of life, and increased mortality rates. The Medication Regimen Complexity Index (MRCI), adapted into Spanish as MRCI-E, measures this complexity by considering factors such as pharmaceutical form, dosing regimen and additional dosing instructions.¹ <h3>Aim and Objectives</h3> The primary aim is to estimate the therapeutic complexity of institutionalised patients upon admission to the Institutionalised Patient Care Unit (UAPI), and to assess the potential reduction in complexity following pharmaceutical interventions on chronic treatment at discharge. The secondary aim is to evaluate whether there is a relationship between therapeutic complexity and the number of hospital visits or readmissions. <h3>Material and Methods</h3> This observational, retrospective study estimates the therapeutic complexity of patients in the UAPI. Patients who underwent medication reconciliation without a report from the socio-healthcare facility were excluded. Data were collected from medical records, nursing home reports and pharmacy databases, and entered in an Excel sheet, which automatically calculated of the complexity scores. A descriptive analysis was performed and the Wilcoxon test was used to evaluate differences in the MRCI-E score before and after pharmaceutical validation. Finally, the association between therapeutic complexity and the number of UAPI visits was analysed by linear regression. <h3>Results</h3> Eighty-eight patients (66% women) with a mean age of 86 years (range 65–99) and an average of 11 prescribed medications were included. Upon admission, the mean MRCI-E score was 30 points which, reduced to 28 after pharmaceutical intervention, with a statistically significant difference (p&lt;0.001). The regression analysis showed that for every additional 20 points in the MRCI-E, there was an increase of 1.17 emergency visits (95% CI 0.61; 1.73, p-value&lt;0.001). <h3>Conclusion and Relevance</h3> The results demonstrate that pharmaceutical intervention can reduce the therapeutic complexity of patients and, therefore, decreasing their associated risk. Additionally, higher MRCI-E scores are found associated with an increased number of emergency hospital visits. <h3>References and/or Acknowledgements</h3> Saez de la Fuente J, Such Diaz A, Cañamares-Orbis I, Ramila E, <i>et al</i>. Cross-cultural Adaptation and Validation of the Medication Regimen Complexity Index Adapted to Spanish. <i>Ann Pharmacother</i> 2016;<b>50</b>(11):918–925. <h3>Conflict of Interest</h3> No conflict of interest