Evaluation of Medication Regimen Complexity Over Time Following Heart Re-Transplantation
1University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO
2University of Colorado School of Medicine, Aurora, CO.
Meeting: 2015 American Transplant Congress
Abstract number: B15
Keywords: Heart transplant patients, Immunosuppression, Retransplantation
Session Information
Session Name: Poster Session B: "A Descent into the Maelstrom": Complications After Heart Transplantation
Session Type: Poster Session
Date: Sunday, May 3, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Medication regimen complexity (MRC) includes many characteristics of a drug regimen. Previously, we showed that MRC is high and persists over time after primary heart transplantation (Tx). The objective of this study was to quantify MRC over time in patients who had undergone heart re-transplantation (re-Tx).
Methods: Medication (med) lists were abstracted at heart re-Tx discharge and years 1 and 3 post re-Tx. Meds were separated into 3 types: Tx, Other prescriptions (Other Rx), and OTC. Meds were counted, and dosage forms, frequencies, and directions were scored using a validated tool. Total MRC scores were calculated, along with scores for each med type. Re-Tx data were compared over time using repeated measures ANOVA, with age at re-Tx as a covariate. Data were compared between cases and matched controls (i.e., primary heart Tx) using unpaired t-tests. Controls were matched to cases (2:1) based on sex, year of Tx (± 4 yrs), and age at Tx (± 5 yrs).
Results: The study included 11 heart re-Tx patients (82% men; re-Tx dates=1997-2012; mean age at re-Tx=48 ± 13 yrs). The table shows MRC scores and med counts (mean ± SD). MRC scores and med counts were high at discharge and persisted over time after re-Tx. In control patients (n=22), total MRC scores were 39.1 ± 10.9, 29.3 ± 6.4, 27.3 ± 6.5, and total med counts were 15.2 ± 4.7, 13.1 ± 2.8, and 11.8 ± 3.1 at Tx discharge, year 1, and year 3, respectively. No values differed significantly between re-Tx patients and controls at any of the time points.
| Re-Tx Patients | Re-Tx Discharge | Year 1 | Year 3 | P value |
| Total MRC score | 37.6 ± 13.8 | 27.7 ± 6.8 | 24.9 ± 6.3 | 0.76 |
| -Total med count | 15.0 ± 5.8 | 12.7 ± 2.6 | 12.4 ± 2.7 | 0.96 |
| Tx med MRC score | 8.3 ± 1.8 | 8.3 ± 1.8 | 7.3 ± 1.9 | 0.72 |
| -Tx med count | 3.0 ± 0 | 2.8 ± 0.4 | 2.7 ± 0.5 | 0.72 |
| Other Rx MRC score | 22.1 ± 11.2 | 12.0 ± 5.1 | 10.0 ± 4.4 | 0.64 |
| -Other Rx count | 8.4 ± 4.8 | 5.8 ± 2.2 | 5.7 ± 2.2 | 0.59 |
| OTC MRC score | 7.3 ± 3.4 | 7.4 ± 2.3 | 7.6 ± 3.0 | 0.80 |
| -OTC count | 3.6 ± 1.7 | 4.1 ± 1.0 | 4.0 ± 1.3 | 0.77 |
Conclusion: MRC persists over time following heart re-Tx. Tx meds account for only about 20% of total MRC score at discharge and 30% of total MRC score at years 1 and 3. MRC was similar between primary Tx and re-Tx patients. Additional studies are needed to evaluate the need for Other Rx and OTC meds, and the relationship between MRC, adherence, and outcomes in primary heart Tx and re-Tx populations.
To cite this abstract in AMA style:
Bryant B, Libby A, Page R, Lindenfeld J, Aquilante C. Evaluation of Medication Regimen Complexity Over Time Following Heart Re-Transplantation [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/evaluation-of-medication-regimen-complexity-over-time-following-heart-re-transplantation/. Accessed November 21, 2024.« Back to 2015 American Transplant Congress