Excessive polypharmacy and complicated medication regimen are associated with Physicians' perceived burden in home healthcare: a multicenter cross-sectional study.

Abstract

Background: Polypharmacy and complex medication regimens are common in home healthcare; however, their impact on physicians' perceived burden remains unclear. This study examined the associations of polypharmacy and medication regimen complexity with physicians' perceived burden in home healthcare.

Methods: A cross-sectional study was conducted at seven home care support clinics and hospitals in Japan. Physicians completed a self-administered questionnaire for patients aged ≥18 years who were receiving home healthcare. Linear mixed-effects models were used to examine the association between the number of medications (categorized into three levels), medication regimen complexity index-Japanese (MRCI-J) scores (categorized into quartiles), and physicians' perceived burden (assessed using a 0-100 mm visual analog scale), with physicians treated as a random effect.

Results: Data were collected from 506 patients, of whom 503 were included in the analyses. The mean patient age was 82.4 years, and the median number of medications was six. The mean score for the physicians' perceived burden was 33.6 mm. Excessive polypharmacy and the highest MRCI-J quartile were significantly associated with greater physician burden even after adjustment for covariates (regression coefficient = 8.20, 95% confidence interval (CI): 4.07-12.33; regression coefficient = 7.84, 95% CI: 3.61-12.07, respectively).

Conclusions: In home healthcare, excessive polypharmacy and complex medication regimens were significantly associated with increased physician burden. These findings underscore the potential benefits of optimizing pharmacotherapy through interprofessional collaboration with community pharmacists to reduce physician workload. Further research is required to identify effective interventions for mitigating this burden. Clinical trial registration: UMIN000056282.