Negewo NA, et al. - Researchers sought to elucidate the associations of medication burden in COPD with clinical outcomes, comorbidities, and multidimensional indices. Findings revealed an association of complex medication regimens with disease severity and specific class of comorbidities in COPD patients.

Methods

• Researchers performed a cross-sectional study, wherein, they assessed COPD patients (n=222) for demographic information, comorbidities, medication use, and clinical outcomes.
• They used the validated medication regimen complexity index (MRCI) to quantify the complexity of medication regimens.

Results

• Data demonstrated that participants (58.6% males) had a mean (SD) age of 69.1 (8.3) years with a postbronchodilator forced expiratory volume in 1 second % predicted of 56.5 (20.4) and a median of five comorbidities.
• It was also noted that the median (q1, q3) total MRCI score was 24 (18.5, 31).
• Researchers observed that COPD-specific medication regimens vs. non-COPD medications were more complex (median MRCI: 14.5 versus 9, respectively; P<0.0001).
• They found that complex dosage formulations contributed the most to higher MRCI scores of COPD-specific medications while dosing frequency primarily drove the complexity associated with non-COPD medications.
• Results also revealed that participants in Global Initiative for Chronic Obstructive Lung Disease quadrant D vs. those in quadrants A (13.5; P=0.0001) and B (12.5; P<0.0001) had the highest median MRCI score for COPD medications (15.5).
• In addition, data indicated significant but weak correlations of increased complexity of COPD-specific treatments with lower lung function and 6-minute walk distance, higher St George’s Respiratory Questionnaire and COPD assessment test scores, and higher number of prior year COPD exacerbations and hospitalizations.
• Findings also showed an individual contribution of comorbid cardiovascular, gastrointestinal, or metabolic diseases to higher total MRCI scores and/or medication counts for all medications.
• Also, it was noted that Charlson Comorbidity Index and COPD-specific comorbidity test displayed the highest degree of correlation with total MRCI score (ρ=0.289 and ρ=0.326; P<0.0001, respectively).