Complexidade da farmacoterapia medida pelo MRCI : uma revisão sistemática para identificar desfechos em saúde

Abstract

The concomitant use of many medicines is a common clinical practice on the world stage. The use of multiple medications per patient may increase the risk of problems related to pharmacotherapy and, consequently, may increase the complexity of pharmacotherapy (CF). In this sense, the objective of this review was to identify the health outcomes associated with CF in studies that use the Medication regimen complexity index (MRCI) as an instrument of analysis. METHODS. A systematic search was performed in the following databases: Cochrane Library, Lilacs, PubMed, Scopus, Embase, Open Thesis and Web of Science, using the following combination of English descriptors: "Outcome assessment AND Drug Therapy AND MRCI" and synonyms. We analyzed studies published until February 2017 in English, Spanish or Portuguese that used the MRCI to measure CF and associate it with a clinical and / or humanistic and / or economic outcome. Two reviewers independently assessed titles, abstracts and full texts according to the eligibility criteria, extracted data and assessed the methodological quality of the studies. RESULTS. 691 Articles Were selected in the initial search, of which 23 complied with the criteria and were included in the review. Eighteen health outcomes associated with CF Were found. The outcomes most influenced by the CF were the clinicians: "Hospital Readmission", "Adherence to Pharmacotherapy" and "Hospitalization". Only One study associated CF with humanistic outcomes and no study made this association with economic outcomes. In addition, 22 different terms were found to refer to CF. Most studies obtained good methodological quality. CONCLUSION. This Review identified some health outcomes that may be influenced by the CF, demonstrating a significant association between the increase in MRCI and these results. This Review also demonstrated the need to standardize the terms and concepts used, allowing the comparison between studies evaluating health outcomes associated with CF.