Differences in Complexity of Discharge Medication Regimens between Men and Women Discharged from Acute Care to Home following Total Joint Arthroplasty

Abstract

Purpose

This study determined whether discharge medication regimens that patients managed at home following hip or knee total joint arthroplasty differed between men and women. Comparisons were made among overall complexity of the regimen and the separate components contributing to complexity: number of medications, dosage forms, dosing frequencies, and additional administration directions.

Methods

Patient demographics and discharge medication regimens for serially discharged patients were retrospectively collected for a 3-month period from medical records at a large urban acute care hospital. Complexity of discharge medication regimens was quantified with the Medication Regimen Complexity Index (MRCI), which accounts for each separate component of complexity.

Results

The serial sample comprised 105 men and 93 women discharged to home following total joint arthroplasty. Men and women did not differ by hospital length of stay or by proportions with the most common secondary diagnoses (hypertension, hyperlipidemia, diabetes). Women were discharged with significantly more complex medication regimens to manage at home than men (P = .047). Among the individual components contributing to complexity, women were discharged with significantly more medications on their lists than men (P = .006) and had significantly larger dosing frequency scores than men (P = .01).

Conclusions

Women discharged to home following lower extremity total joint arthroplasty may be at greater risk for an adverse drug event than men due to increased medication regimen complexity. These findings suggest that attempts should be made to mitigate this risk through reduced regimen complexity, specifically targeting dosing frequency, increased education for patients with complex regimens, or increased monitoring.