Integrating Drug Utilisation Review and Medication Regimen Complexity Index to Enhance Safety and Adherence in Gynaecological Pharmacotherapy

Background Drug Utilisation Review (DUR) and the Medication Regimen Complexity Index (MRCI) are emerging tools to optimise prescribing, minimise regimen burden and improve outcomes in gynaecological pharmacotherapy. However, their application in routine clinical practice remains underexplored. Purpose To evaluate medication utilisation patterns and regimen complexity in gynaecological patients using DUR and MRCI, and to identify the impact of complexity on adherence and clinical outcomes. Materials and Methods A prospective observational study was conducted on 300 gynaecological patients attending the gynaecology department of a government hospital in Dharashiv. Demographic, clinical and prescribing data were collected and analysed using Statistical Package for Social Sciences. Descriptive statistics were presented as mean ± SD, percentage and 95% confidence intervals (CIs). One-way analysis of variance was used for group comparisons, while chi-square ( χ ²) tests were used to assess associations between MRCI and clinical parameters. Results The majority of patients were in the 26–30-year age group (19.33%, p < .0001*), and 28.3% were overweight/obese ( p < .0001*). Anaemia (Hb < 11 g/dL) was observed in 49.16% of cases ( p < .05*). The most frequently prescribed drugs included Ceftriaxone (84.3%, p < .05*), Pantoprazole (77.6%, p < .05*) and Ondansetron (65%, p < .05*), with high rates of empirical antibiotic use. MRCI analysis revealed that 50.3% of patients had high regimen complexity (>20, p < .05*), 33.6% moderate (11–20, p < .05*) and 16% low (≤10, p < .05*). Significant associations were noted between MRCI and anaemia ( χ ² = 10.62, p = .0049*), and between MRCI and polypharmacy ( χ ² = 45.13, p < .001*), while no association was observed with place of residence ( p = .81, ns). Conclusion This study demonstrated a high prevalence of anaemia, empirical antibiotic prescribing and complex regimens in gynaecological patients. DUR and MRCI proved useful in identifying inappropriate prescribing and quantifying regimen complexity. Incorporating pharmacist-led counselling, multidisciplinary care and AI-driven DUR systems may help improve adherence, reduce polypharmacy and optimise pharmacotherapy in gynaecological practice.