Reducing medication regimen complexity - A controlled trial

OBJECTIVE: To determine if a visual intervention [medication grid) delivere d to physicians can reduce medication regimen complexity. DESIGN: Nonrandomized, controlled trial. SETTING: Veterans Affairs medical center. PATIENTS/PARTICIPANTS: Eight hundred thirty-six patients taking at least 5 medications at the time of admission and the 48 teams of physicians and stu dents on the general medicine inpatient service. INTERVENTION: For intervention patients, a medication grid was created that displayed all of the patients' medicines and the times of administration f or 1 week. This grid was delivered to the admitting resident soon after adm ission. MEASUREMENTS AND MAIN RESULTS: For the patients of each team of physicians, we calculated the change in the average number of medications and doses fr om admission to discharge. The number of medications in the Intervention gr oup decreased by 0.92 per patient, and increased by 1.65 in the control gro up (P <.001). The mean number of doses per day in the intervention group de creased by 2.47 per patient and increased by 3.83 in the control group (P < .001). CONCLUSIONS: This simple intervention had a significant impact on medicatio n regimen complexity in this population. Apparently, physicians were able t o address polypharmacy when the issue was brought to their attention.