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ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 15 - 2024 |
doi: 10.3389/fphar.2024.1448986
This article is part of the Research Topic Clinical Pharmacist Service Promotes the Improvement of Medical Quality Volume II View all 3 articles
Association between medication complexity and follow-up care attendance: insights from a retrospective multicenter cohort study across 1,223 Chinese hospitals
Provisionally accepted- 1 School of Population Medicine and Public Health, Peking Union Medical College Hospital (CAMS), Dongcheng, China
- 2 Department of Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China
- 3 National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Mentougou, Beijing, China
- 4 Department of Pharmacy, The First Affiliated Hospital of University of Science and Technology of China Anhui Provincial Hospital, Hefei, Anhui Province, China
- 5 School of Clinical Medicine, Department of Life Sciences and Medicine,University of Science and Technology of China, Hefei, Anhui Province, China
- 6 Department of Pharmacy, Hebei General Hospital, Shijiazhuang, China
- 7 Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- 8 Department of Pharmacy, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- 9 Institute for Hospital Management, Tsinghua University, Beijing, China
- 10 International Research Center for Medicinal Administration, School of Pharmaceutical Sciences, Peking University, Beijing, China
- 11 Department of Pharmacology, China-Japan Friendship Hospital, Beijing, Beijing Municipality, China
- 12 School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing Municipality, China
- 13 Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, Beijing Municipality, China
Background: Patients with Chronic Obstructive Pulmonary Disease (COPD) frequently face substantial medication burdens. Follow-up care on medication management is critical in achieving disease control. This study aimed to analyze the complexity of COPD-specific medication and determine how it impacted patients' attendance on follow-up care.Methods: This multicenter study includes patients with COPD from 1,223 hospitals across 29 provinces in China from January 2021 to November 2022. The medication Regimen Complexity Index (MRCI) score was used to measure COPD-specific medication complexity. The association between medication complexity and follow-up care attendance was evaluated using the Cox Proportional Hazard Model.Results: Among 16,684 patients, only 2,306 (13.8%) returned for follow-up medication management. The median MRCI score was 8.0 (Interquartile Range [IQR], 5.0 to 14.0).20.3% of the patients had high complex medication regimen (MRCI score > 15.0). The analysis revealed that compared to those with less complex regimens, patients with more complex medication regimens were significantly less likely to attend the follow-up medication care, with a Hazard Ratio (HR) of 0.82 (95% Confidence Interval [CI], 0.74 to 0.91). Specifically, patients with more complex dosage forms were 51% less likely to attend the follow-up care (95% CI, 0.43 to 0.57). This pattern was especially marked among male patients, patients younger than 65 years, and those without comorbid conditions.Higher medication complexity was associated with a decreased likelihood of attending follow-up care. To promote care continuity in chronic disease management, individuals with complex medication regimens should be prioritized for enhanced education. Furthermore, pharmacists collaborating with respiratory physicians to deprescribe and simplifydeprescribing and simplifying dosage forms should be considered in the disease management process.*a Adjusted for age and sex.†b Adjusted for age, sex, body mass index, systolic blood pressure, heart rate, and COPD Assessment Test.
Keywords: follow-up care attendance, Medication regimen complexity, medication management, Chronic disease management, Chronic Obstructive Pulmonary Disease sex, ethnicity, Body Mass Index, systolic blood pressure
Received: 14 Jun 2024; Accepted: 08 Jul 2024.
Copyright: © 2024 Ma, Wang, Chen, Lian, Zhao, He, Qiu, Han, Liu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yongwu Chen, Department of Pharmacy, The First Affiliated Hospital of University of Science and Technology of China Anhui Provincial Hospital, Hefei, 230001, Anhui Province, China
Yufei Lian, Department of Pharmacy, Hebei General Hospital, Shijiazhuang, China
Xiaoyu Zhao, Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
Yue Qiu, Institute for Hospital Management, Tsinghua University, Beijing, China
Sheng Han, International Research Center for Medicinal Administration, School of Pharmaceutical Sciences, Peking University, Beijing, China
Lihong Liu, Department of Pharmacology, China-Japan Friendship Hospital, Beijing, Beijing Municipality, China
Chen Wang, School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, Beijing Municipality, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Yongwu Chen
4,5*