Abstract / Summary
Abstract Objective To analyze the factors associated with the complexity of pharmacotherapy in individuals with rheumatoid arthritis (RA). Method A cross-sectional study was conducted in a teaching hospital in the central-western region of Brazil between October and December 2023. A sociodemographic and health questionnaire and the Medication Regimen Complexity Index (MRCI) were used. The levels of pharmacotherapy complexity were segmented into low, intermediate, and high for comparisons. Descriptive and analytical statistics were employed using Pearson’s chi-square and Fisher’s exact tests, as well as Spearman’s correlation test and multivariable linear regression. Results Ninety-six individuals were included in the sample. Most participants presented intermediate pharmacological complexity. The sample had a mean age of 59.6 ± 10.3 years, with a predominance of female participants across all complexity levels. In the bivariate analysis, female sex and the absence of a spouse were associated with greater pharmacotherapeutic complexity; however, these associations did not remain statistically significant in the multivariable model. In the multivariable linear regression model (adjusted R² = 0.441), a greater number of comorbidities (B = 2.07; p < 0.001) and greater pain intensity (B = 0.54; p = 0.009) were independently associated with greater pharmacotherapeutic complexity, while illiterate or elementary education level was associated with higher complexity scores compared to high school or higher education (B = 3.62; p = 0.011), indicating a possible protective role of higher education. Furthermore, individuals on combination therapy presented greater pharmacotherapeutic complexity compared to those on monotherapy (B = 4.07; p = 0.006). Although sex was included in the multivariable model, it did not show a statistically significant association with pharmacotherapeutic complexity (B = -2.82; p = 0.19). Conclusion Comorbidities, education level, pain intensity, and combination pharmacotherapy were associated with higher pharmacotherapy complexity in individuals with RA. These findings suggest that healthcare services should prioritize the identification of patients with these characteristics for multidisciplinary assessment aimed at optimizing and simplifying pharmacotherapy.