George et al developed the Medication Regimen Complexity Index (MRCI) to evaluate the complexity of a patient's drug therapy. The complexity of therapy can impact adherence and outcomes. The authors are from Monash University and The Alfred Hospital in Melbourne, Australia.
The MRCI consists of 3 subscores:
(1) dosage forms
(2) dosing frequency
(3) additional dosing instructions
Additional directions weighted at 1 point:
(1) need to break or crush a tablet
(2) need to dissolve or mix a tablet or powder
(3) need to take more than 1 unit (tablet, capsule, puff, etc) at a time
(4) variable dose
(5) taking a dose at a specific time of day
(6) taking the dose relative to a meal
(7) taking the dose with a specific food
Additional directions weighted at 2 points:
(1) take or use as directed
(2) dose that is gradually decreasing (tapering)
(3) dose that is gradually increasing
(4) a dose that alternates
where:
• A drug that needs to be taken around the clock (resulting in a need to awaken at night) might need to be weighted more than 1.
value for each additional direction =
= (weighting for each additional direction) * (number of drugs dosed with that direction)
subscore for additional directions =
= SUM(values for all of the additional directions)
