The Association of Medication Complexity with COVID-19 Severity and its Impact on Pharmacotherapy Evaluation

Background: Off-level medicines do not provide adequate health outcomes since there is insufficient efficacy and/or toxicity evidence. Offlevel medicines are more vulnerable to adverse drug reactions (ADRs), which are a prominent cause of morbidity and mortality. Objective of the study is to determine the relationship between the medication complexity and severity of COVID-19 and its impact on pharmacotherapy evaluation.Materials and Methods: A prospective, cross-sectional study was conducted in the COVID ward where medication complexity was assessed for all prescriptions on admission using the Medical Regimen Complexity Index’s guidelines and subjected to pharmacotherapy evaluation. Results: Overall, the patients spent an average of 7.55 ± 3.60 days in the hospital. Each prescription contained an average of 6.54 ± 2.51 drugs. Polypharmacy was found in 82.70% (263) of the prescriptions, while medication duplication was found in 17.29% (55), severe drug interactions accounted for 83.01% (264), and drug dosage adjustment was performed in 10.06% (32). The mean medication complexity was 26.86 ± 7. 58. When comparing medication complexity concerning the severity of COVID-19, we found that the average medication complexity score for mild was 24.62 ± 6.04, moderate was 31.65 ± 8.39, severe was 35.19 ± 6.81, and critical was 28.59 ± 8.60. we found a statistically significant positive correlation between the medical complexity and the hospital stay (P-value, 0.000), and there was an association between the medication complexity and the Covid-19 severity (p <0.001). Conclusion: The assessment of the medication complexity in routine pharmacotherapy evaluations could be beneficial in alerting potential risks, suggesting additional focus wherever required, and decreasing the financial burden by reducing hospital stay. It demonstrated an association between medication complexity and the severity of COVID-19.