Identification of drug-related problems in ambulatory chronic kidney disease patients: a 6-month prospective study

Belaiche, Stéphanie; Romanet, Thierry; Allenet, Benoît; Calop, J.; Zaoui, Philippe

doi:10.5301/jn.5000063

Cited by 39 publications

(60 citation statements)

References 19 publications

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“…[4][5][6] In the present study, more than 85% of patients experienced at least one medication error that is comparable to reported medication error rates in CKD patients by other researchers. 7 In our survey, the rates of medication errors were 3.5 errors per patient and 0.18 errors per ordered medication that is more than those reported from the infectious disease ward of the same hospital (0.3 errors per patient and 0.05 errors per ordered drug). 12 These differences may be due to more co-morbidities, polypharmacy, and drug pharmacokinetic changes in CKD patients that predispose physicians, nurse, and patients to more medication errors.…”

Section: Discussionmentioning

confidence: 66%

“…Medication errors were correlated with older age and number of ordered medications. 7 Parallel results on the types of medication errors, clinical pharmacists' interventions, and drug classes with most errors were reported from a survey in an Austrian nephrology ward. 18 As seen, our findings are consistent with these results.…”

Section: Discussionmentioning

confidence: 83%

“…These correlations have been reported from other study on patients with renal insufficiency as well. 7 The present study estimated that clinical pharmacists' interventions decrease patients' direct medication costs by 4.3%. In this study, despite the high prevalence of omission drug as medication errors that resulted in increased medication cost following clinical pharmacists' interventions, the direct medication cost even decreased by clinical pharmacists' contributions.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6] Some reports show that more than 85% of CKD patients experience at least one medication error. 7 Untreated indications and incorrect dosage are common types of medication errors among CKD and hemodialysis patients. [5][6][7][8][9] Clinical pharmacists play important roles in detection and prevention of medication errors.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7][8][9] Clinical pharmacists play important roles in detection and prevention of medication errors. [4][5][6][7][8] Clinical pharmacy services started during last two decades in a few teaching hospitals in Iran. There are few reports on medication errors surveillance in hospitalized patients in Iran and clinical pharmacists' interventions to prevent or reduce these errors.…”

Section: Introductionmentioning

confidence: 99%

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Frequency, types, and direct related costs of medication errors in an academic nephrology ward in Iran

et al. 2014

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Medication errors are ongoing problems among hospitalized patients especially those with multiple co-morbidities and polypharmacy such as patients with renal diseases. This study evaluated the frequency, types and direct related cost of medication errors in nephrology ward and the role played by clinical pharmacists. During this study, clinical pharmacists detected, managed, and recorded the medication errors. Prescribing errors including inappropriate drug, dose, or treatment durations were gathered. To assess transcription errors, the equivalence of nursery charts and physician's orders were evaluated. Administration errors were assessed by observing drugs' preparation, storage, and administration by nurses. The changes in medications costs after implementing clinical pharmacists' interventions were compared with the calculated medications costs if the medication errors were continued up to patients' discharge time. More than 85% of patients experienced medication error. The rate of medication errors was 3.5 errors per patient and 0.18 errors per ordered medication. More than 95% of medication errors occurred at prescription nodes. Most common prescribing errors were omission (26.9%) or unauthorized drugs (18.3%) and low drug dosage or frequency (17.3%). Most of the medication errors happened on cardiovascular drugs (24%) followed by vitamins and electrolytes (22.1%) and antimicrobials (18.5%). The number of medication errors was correlated with the number of ordered medications and length of hospital stay. Clinical pharmacists' interventions decreased patients' direct medication costs by 4.3%. About 22% of medication errors led to patients' harm. In conclusion, clinical pharmacists' contributions in nephrology wards were of value to prevent medication errors and to reduce medications cost.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Frequency, types, and direct related costs of medication errors in an academic nephrology ward in Iran

et al. 2014

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The effect of size, charge, and peptide ligand length on kidney targeting by small, organic nanoparticles

Huang

Jiang

Zhang

et al. 2020

Bioengineering & Transla Med

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Chronic kidney disease (CKD) affects 15% of the US adult population. However, most clinically available drugs for CKD show low bioavailability to the kidneys and non-specific uptake by other organs which results in adverse side effects. Hence, a targeted, drug delivery strategy to enhance kidney drug delivery is highly desired. Recently, our group developed small, organic nanoparticles called peptide amphiphile micelles (PAM) functionalized with the zwitterionic peptide ligand, (KKEEE) 3 K, that passage through the glomerular filtration barrier for kidney accumulation. Despite high bioavailability to the kidneys, these micelles also accumulated in the liver to a similar extent. To further optimize the physicochemical properties and develop design rules for kidney-targeting micelles, we synthesized a library of PAMs of varying size, charge, and peptide repeats. Specifically, variations of the original (KKEEE) 3 K peptide including (KKEEE) 2 K, (KKEEE)K, (EEKKK) 3 E, (EEKKK) 2 E, (EEKKK)E, KKKKK, and EEEEE were functionalized onto nanoparticles, and peptide surface density and PEG linker molecular weight were altered. After characterization with transmission electron microscopy (TEM) and dynamic light scattering (DLS), nanoparticles were intravenously administered into wildtype mice, and biodistribution was assessed through ex vivo imaging. All micelles localized to the kidneys, but nanoparticles that are positively-charged, close to the renal filtration size cutoff , and consisted of additional zwitterionic peptide sequences generally showed higher renal accumulation. Upon immunohistochemistry, micelles were confirmed to bind to the multiligand receptor, megalin, and histological analyses showed no tissue damage. Our study provides insight into the design of micelle carriers for kidney targeting and their potential for future therapeutic application.

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Clinical pharmacist as a member of the multidisciplinary kidney care team in low‐ and middle‐income countries: An opportunity to reduce the incidence of drug‐related problems

Okoro

2021

J Am Coll Clin Pharm

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The multiple comorbidities, complications, and polypharmacy coupled with pharmacokinetic and pharmacodynamics changes linked to chronic kidney disease (CKD) predispose patients with this disease to a huge number of drug-related problems (DRPs).Evidence has shown that a clinical pharmacist (CP) is an integral member of the multidisciplinary kidney care team in most high-income countries (HICs). In the team, CP provides patient-centered care, including detection, prevention, and resolution of DRPs, and helping patients overcome challenges to improve drug adherence. Pharmaceutical care in CKD has demonstrated positive economic, clinical, and humanistic outcomes including reduced DRPs, all-cause hospital admission, length of hospital stays, the incidence of end-stage renal disease, and mortality, improved drug knowledge, adherence, health-related quality of life among others. The purpose of this article is to highlight the gaps in drug-related care for patients with CKD in low-and middle-income countries (LMICs), demonstrate that clinical pharmacy services have the capacity to reduce these gaps, identify barriers that hinder its implementation in LMICs and offer recommendations capable of mitigating the identified barriers.

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Identification of drug-related problems in ambulatory chronic kidney disease patients: a 6-month prospective study

Abstract: A formatted CP evaluation coupled with a renal consultation was able to detect a higher level of DRPs, to reinforce educational messages and to propose immediate changes in the therapeutic project.

Cited by 39 publications

References 19 publications

Frequency, types, and direct related costs of medication errors in an academic nephrology ward in Iran

Frequency, types, and direct related costs of medication errors in an academic nephrology ward in Iran

The effect of size, charge, and peptide ligand length on kidney targeting by small, organic nanoparticles

Clinical pharmacist as a member of the multidisciplinary kidney care team in low‐ and middle‐income countries: An opportunity to reduce the incidence of drug‐related problems

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