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Reducing medication regimen complexity

A controlled trial

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Abstract

OBJECTIVE: To determine if a visual intervention (medication grid) delivered to physicians can reduce medication regimen complexity.

DESIGN: Nonrandomized, controlled trial.

SETTING: Veterans Affairs medical center.

PATIENTS/PARTICIPANTS: Eight hundred thirty-six patients taking at least 5 medications at the time of admission and the 48 teams of physicians and students on the general medicine inpatient service.

INTERVENTION: For intervention patients, a medication grid was created that displayed all of the patients’ medicines and the times of administration for 1 week. This grid was delivered to the admitting resident soon after admission.

MEASUREMENTS AND MAIN RESULTS: For the patients of each team of physicians, we calculated the change in the average number of medications and doses from admission to discharge. The number of medications in the intervention group decreased by 0.92 per patient, and increased by 1.65 in the control group (P<.001). The mean number of doses per day in the intervention group decreased by 2.47 per patient and increased by 3.83 in the control group (P<.001).

CONCLUSIONS: This simple intervention had a significant impact on medication regimen complexity in this population. Apparently, physicians were able to address polypharmacy when the issue was brought to their attention.

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Authors and Affiliations

  1. Received from the Division of Gastroenterology, Duke University Medical Center, USA

    Andrew J. Muir MD

  2. Department of Medicine, Duke University Medical Center, USA

    Linda L. Sanders MS

  3. Division of Biometry, Department of Community and Family Medicine, Duke University Medical Center, USA

    William E. Wilkinson PhD

  4. Division of Geriatrics, Department of Medicine and the Center for the Study of Aging and Human Development, Duke University Medical Center, USA

    Kenneth Schmader MD

  5. Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, NC

    Kenneth Schmader MD

Authors
  1. Andrew J. Muir MD
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  2. Linda L. Sanders MS
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  3. William E. Wilkinson PhD
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  4. Kenneth Schmader MD
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Corresponding author

Correspondence to Andrew J. Muir MD.

Additional information

This work was supported by the Geriatric Research Education and Clinical Center (GRECC) of the Durham VAMC, and by the Duke Claude D. Pepper Older Americans Independence Center, no. 1P60AG11268-02.

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Muir, A.J., Sanders, L.L., Wilkinson, W.E. et al. Reducing medication regimen complexity. J GEN INTERN MED 16, 77–82 (2001). https://doi.org/10.1046/j.1525-1497.2001.016002077.x

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  • DOI: https://doi.org/10.1046/j.1525-1497.2001.016002077.x

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