The Impact of Medication Regimen Complexity on Patient‐Related and Clinical Outcomes in Patients Undergoing Hemodialysis
Bibliographic record
Abstract
INTRODUCTION: There is limited data on medication regimen complexity on outcomes in patients with kidney failure receiving hemodialysis (HD) in different settings. This study aims to quantify medication regimen complexity and assess its impact on patient-related and clinical outcomes in facility-based and home-based HD-treated patients. METHODS: This study targeted patients undergoing HD at a large metropolitan dialysis center in Australia. Baseline data and hospitalizations were recorded through a retrospective audit of electronic medical records, while other outcome data were collected prospectively. Medication regimen complexity was assessed using the 65-item Medication Regimen Complexity Index (MRCI). Medication adherence was evaluated with the 4-item Morisky-Green-Levine Scale (MGLS), whereby participants were deemed not adherent if they responded "yes" to any of the questions. EQ-5D-5L and EQ VAS scores were used to assess health-related quality of life (HRQoL) with higher scores indicating better health. FINDINGS: Of 174 eligible adults, 145 (80 facility-based and 65 home HDs) patients participated. Participants of both facility-based and home HD were predominantly men (65% and 75.4%, respectively) with a mean age of 62 ± 13 years and 56 ± 12 years, respectively. Home HD participants had a higher median MRCI than those on facility-based HD [26.0 (IQR 20.6-33.0) vs. 20.8 (IQR 13.6-28.4), respectively; p = 0.005]. While there was no significant difference in the non-adherence rate, home HD participants had higher scores for both EQ-5D-5L [0.917 (IQR 0.745-0.984) vs. 0.798 (IQR 0.302-0.956), respectively; p = 0.006] and EQ VAS [60 (IQR 50-75) vs. 50 (IQR 40-70), respectively; p = 0.034]. Home HD participants also had a fewer number of hospitalizations in the prior (1 year 0 (IQR 0-1) vs. 1 (IQR 0-1), respectively; p = 0.042). DISCUSSION: The higher complexity of the medication regimen for home HD compared to facility-based HD participants may be due to the shift in dose administration responsibility of several parenteral medications. Despite the higher complexity, home HD patients had better outcomes, including HRQoL and hospitalizations compared to facility-based HD patients.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".