• A Carmine Colavecchia, David R Putney, Michael L Johnson, and Rajender R Aparasu.
• Houston Methodist Hospital, Department of Pharmacy, 6565 Fannin St., DB1-09, Houston, TX 77030, United States. Electronic address: accolavecchia@houstonmethodist.org.
• Res Social Adm Pharm. 2017 Jul 1; 13 (4): 857-863.

BackgroundLimited research exists regarding Medication Regimen Complexity Index (MRCI) and its utility in identifying patients at risk for hospital readmission.ObjectiveThis study evaluates the association between discharge MRCI and 30-day rehospitalization in patients with heart failure (HF) after discharge.MethodsThe study involved a retrospective, cohort study at a large tertiary teaching facility from the University HealthSystem Consortium. The consortium database was used to identify HF patients hospitalized from January 2011 to December 2013. A 30-day readmission was defined as being readmitted to the same hospital within 30 days of discharge with a principal discharge diagnosis of HF. Index hospitalizations was defined as the first hospitalization, and readmission was the subsequent hospitalization for HF. A pilot analysis was conducted to compare manual MRCI collection tool and a computerized scoring MRCI system. Multivariable logistic regression was used to examine the association of computerized MRCI (≥15) and 30-day rehospitalization after controlling for other variables.ResultsA total of 1,452 patients were included in the study with 81 patients (5.9%) readmitted within 30 days of discharge. The manual and computerized MRCIs were correlated with an R of 0.74 and R2 of 0.55. The multivariate logistic regression analysis found computerized MRCI ≥15 (OR: 1.62; 95% CI: 1.01-2.59) was associated with 30-day rehospitalization after controlling for other factors. Patients prescribed angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers, were less likely (OR: 0.54; CI: 0.33-0.89) to be readmitted 30 days after discharge, and patients with coronary artery disease were more likely (OR: 1.76; CI: 1.03-3.00) to be readmitted 30 days after discharge.ConclusionsThe computerized MRCI score was moderately correlated with manual MRCI score. A significant association was found between computerized MRCI and 30-day HF readmission. Such predictive tools may allow pharmacists to prioritize patient care and optimize patient outcomes through medication therapy management.Copyright © 2016 Elsevier Inc. All rights reserved.

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