{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T22:45:43Z","timestamp":1767912343594,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,23]],"date-time":"2025-02-23T00:00:00Z","timestamp":1740268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>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\u2010related and clinical outcomes in facility\u2010based and home\u2010based HD\u2010treated patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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\u2010item Medication Regimen Complexity Index (MRCI). Medication adherence was evaluated with the 4\u2010item Morisky\u2010Green\u2010Levine Scale (MGLS), whereby participants were deemed not adherent if they responded \u201cyes\u201d to any of the questions. EQ\u20105D\u20105L and EQ VAS scores were used to assess health\u2010related quality of life (HRQoL) with higher scores indicating better health.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Of 174 eligible adults, 145 (80 facility\u2010based and 65 home HDs) patients participated. Participants of both facility\u2010based and home HD were predominantly men (65% and 75.4%, respectively) with a mean age of 62\u2009\u00b1\u200913\u2009years and 56\u2009\u00b1\u200912\u2009years, respectively. Home HD participants had a higher median MRCI than those on facility\u2010based HD [26.0 (IQR 20.6\u201333.0) vs. 20.8 (IQR 13.6\u201328.4), respectively; <jats:italic>p<\/jats:italic>\u2009=\u20090.005]. While there was no significant difference in the non\u2010adherence rate, home HD participants had higher scores for both EQ\u20105D\u20105L [0.917 (IQR 0.745\u20130.984) vs. 0.798 (IQR 0.302\u20130.956), respectively; <jats:italic>p<\/jats:italic>\u2009=\u20090.006] and EQ VAS [60 (IQR 50\u201375) vs. 50 (IQR 40\u201370), respectively; <jats:italic>p<\/jats:italic>\u2009=\u20090.034]. Home HD participants also had a fewer number of hospitalizations in the prior (1\u2009year 0 (IQR 0\u20131) vs. 1 (IQR 0\u20131), respectively; <jats:italic>p<\/jats:italic>\u2009=\u20090.042).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The higher complexity of the medication regimen for home HD compared to facility\u2010based 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\u2010based HD patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hdi.13214","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T18:51:48Z","timestamp":1740595908000},"page":"231-236","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Impact of Medication Regimen Complexity on Patient\u2010Related and Clinical Outcomes in Patients Undergoing Hemodialysis"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4061-1722","authenticated-orcid":false,"given":"Jing Xin","family":"Goh","sequence":"first","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine and Health The University of Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wubshet","family":"Tesfaye","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine and Health The University of Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Connie","family":"Van","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine and Health The University of Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamal","family":"Sud","sequence":"additional","affiliation":[{"name":"Sydney Medical School, Faculty of Medicine and Health The University of Sydney  Sydney Australia"},{"name":"Department of Renal Medicine Nepean Kidney Research Centre, Nepean Hospital  Kingswood Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shrey","family":"Seth","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine and Health The University of Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Surjit","family":"Tarafdar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Blacktown Hospital, WSLHD  Blacktown Australia"},{"name":"Faculty of Medicine Western Sydney University  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald L.","family":"Castelino","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine and Health The University of Sydney  Sydney Australia"},{"name":"Pharmacy Department Blacktown Hospital, WSLHD  Blacktown Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,2,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfu015"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0144119"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2020.10.011"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17010371"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1D479"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2013.02.019"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-198601000-00007"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2019.00168"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.7897\/2230-8407.1007234"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000328391"},{"key":"e_1_2_10_12_1","unstructured":"\u201cEuroQol website: EQ\u20105D\u20105L | About \u201d2021."},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-4758.2011.00539.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfu091"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00290109"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000446450"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd19.220062"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000485159"},{"issue":"6","key":"e_1_2_10_19_1","article-title":"Survival Comparisons of Home Dialysis Versus in\u2010Center Hemodialysis: A Narrative Review","volume":"13","author":"Vinson A. 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