Evaluation of Medication Regimen Complexity (MRC) and Pharmacist Interventions Utilizing the MRC‐ICU Scoring Tool in Hematology/Oncology Patients: A Cohort Study

ABSTRACT Background The medication regimen complexity‐intensive care unit ( MRC ‐ ICU ) score is a validated scoring tool to assess the complexity of medication regimens and can be used as a surrogate marker for pharmacist interventions. Hospitalized oncology patients often require extensive pharmacotherapy regimens like those requiring intensive care. Validation of the MRC ‐ ICU scoring tool in this population would allow for proactive assessment of patient complexity and optimal allocation of pharmacy resources. The objective of this investigation was to validate the MRC‐ICU scoring tool in hematology/oncology patients as a surrogate for pharmacist interventions. Methods Patients admitted to an inpatient hematology service or the ICU for over 24 h were identified for inclusion. Patient demographics and pharmacist interventions were collected, and MRC‐ICU scores were calculated for every day of admission. Four items specific to oncology care were added to the original scoring tool to produce a modified score (oMRC‐ICU). The primary end point was the correlation between oMRC‐ICU scores and pharmacist interventions. Secondary end points were correlations between oMRC‐ICU scores and patient outcomes, service, and intervention type. Descriptive statistics were used to report patient demographics and outcomes data. Spearman's rank correlation and Lasso regression were used to define end points of interest. Results A total of 138 admissions were included, corresponding to 129 unique patients. Most admissions (65.2%) were to a hematology service. The median length of stay was 5 days (range 2–9) and the median time to maximum score was 1.5 days (interquartile range IQR 1–6). Chemotherapy, opioids/sedatives, and antimicrobials provided the highest average point contributions to MRC‐ICU scores (additional data can be found in the Supporting Information). There was a strong, positive correlation between total pharmacist interventions and maximum MRC‐ICU score ( R s = 0.55, p < 0.0001) and oMRC‐ICU score ( R s = 0.57, p < 0.0001). Conclusion MRC‐ICU scores are a validated surrogate marker for pharmacist interventions in hematology/oncology patients and can be utilized as a measure of pharmacist productivity without the need for daily documentation.