Strategies to simplify complex medication regimens
J. Simon Bell, Brigid McInerney, Esa Y. H. Chen, Phillip J. Bergen, Lorenna Reynolds, Janet K. Sluggett
Abstract
BACKGROUND: Older people use increasingly complex medication regimens. Complex regimens are challenging to administer, particularly for those with cognitive impairment, frailty, poor eyesight or limited dexterity. Complex regimens have been linked to non-adherence, medication errors and hospital admissions. OBJECTIVE: The aim of this article is to describe strategies to reduce the complexity of medication regimens in community and residential aged care settings. DISCUSSION: Medication regimen simplification is the process of reducing medication burden through strategies such as consolidating dosing times, standardising routes of administration, using long-acting rather than shorter-acting formulations, and switching to combination products in place of single-ingredient products. Obtaining a best possible medication history, ensuring appropriateness of current therapy, and deprescribing are important steps prior to implementing regimen simplification. Implementing such strategies should be based on a discussion and consideration of patient preferences, and include clinical judgement to limit the risk of unintended consequences for patients or carers.