Complex medication regimens may be risky and burdensome for community-dwelling older adults suffering from dementia or mild cognitive impairment. Providers should look for ways to reduce overprescribing certain medicines to this group, a new study finds.
Researchers from Johns Hopkins University School of Medicine and Mayo Clinic conducted a cross-sectional study using existing medical record data from seven Minnesota counties in the Rochester Epidemiology Project medical records-linkage system. They analyzed records of nearly 4,000 older residents with dementia or mild cognitive impairment for outpatient medication prescriptions and self-reported medications in the 30 days before and after their dementia diagnoses.
The researchers found substantial variances in the frequency and types of medicines that were prescribed to these patients.
“Complex medication regimens may increase the risk of poor health outcomes,” the study’s authors wrote. “Opioids and antidepressants were among the top 10 most common medication classes in our cohort. Reducing the use of central nervous system-active medications may be important to reducing complexity for this population, as use of such medications is common among people living with dementia and associated with numerous adverse health outcomes.”
The researchers say enhanced use of the Medication Regimen Complexity Index (MRCI), which incorporates dosage form, frequency and additional directions, may be a useful tool to identify people with dementia or MCI who would benefit from deprescribing.
“In conclusion, this study characterized medication regimen complexity among people with MCI or dementia,” the authors wrote. “Future studies should assess the impact of reducing MRCI scores on clinical outcomes, including adverse events and patient- or caregiver-reported measures of treatment burden.”
Findings of the study appeared March 21 in the Journal of the American Geriatrics Society.
