Impact of hospitalisation on the complexity of older patients' medication regimens and potential for regimen simplification

Aim: To investigate the impact of hospitalisation on the complexity of older patientsa?? medication regimens; and to determine whether discharge medication regimens could be simplified. Method: Medication Regimen Complexity Index (MRCI) scores were calculated on admission and discharge for 186 consecutive patients (mean age 80 years) discharged from 2 acute general medicine and 2 subacute aged care wards. A random sample of 40 discharge medication regimens were retrospectively simplified by clinical pharmacists and proposed changes reviewed by a clinical pharmacologist to determine feasibility of the changes and likelihood of equivalent therapeutic outcomes.