Medication Reconciliation: The Foundation of Medication Safety for Patients Requiring Dialysis

Frament, Jill; Hall, Rasheeda K.; Manley, Harold J.

doi:10.1053/j.ajkd.2020.07.021

Cited by 22 publications

(24 citation statements)

References 31 publications

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“…Medication errors can be attributed to discrepancies in medication history at the time of care transition. Therefore, the MR service is an important component of a mediation safety program for patients with advanced-stage CKD [ 39 ]. It has been reported that approximately 34% of medication discrepancies are potentially harmful [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Clinical Pharmacist Service on Drug-Related Problems and Patient Outcomes for Hospitalized Patients with Chronic Kidney Disease: A Randomized Controlled Trial

Song

Jeong

Han

et al. 2021

JCM

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(1) Background: The study aimed to analyze the effectiveness of clinical pharmacist services on drug-related problems (DRPs) and patient outcomes in inpatients with chronic kidney disease (CKD). (2) Methods: In a randomized controlled trial, the participants in the intervention group received pharmacist services, including medication reconciliation, medication evaluation and management, and discharge pharmaceutical care transition services. Participants in the control group received usual care. The primary outcome was the number of DRPs per patient at discharge. (3) Results: The baseline characteristics of 100 participants included the following: mean age, 52.5 years; median eGFR, 9.2 mL/min/1.73 m2. The number of DRPs in the intervention group during hospitalization increased significantly with decreasing eGFR (PR, 0.970; 95% CI, 0.951–0.989) and an increasing number of unintentional medication discrepancies at admission (PR, 1.294; 95% CI, 1.034–1.620). At discharge, the number of DRPs per patient was 0.94 ± 1.03 and 1.96 ± 1.25 in the intervention and control groups, respectively (p < 0.001). The service had a significant effect on the reduction of the unintentional discrepancies at discharge (p < 0.001). (4) Conclusion: Hospital pharmacists play an important role in the prevention of DRPs at discharge and unintentional medication discrepancies in inpatients with CKD.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Clinical Pharmacist Service on Drug-Related Problems and Patient Outcomes for Hospitalized Patients with Chronic Kidney Disease: A Randomized Controlled Trial

Song

Jeong

Han

et al. 2021

JCM

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“…Strategies to facilitate safe ESKD care may involve comprehensive medication review and reconciliation for dialysis patients. 26 Effective ESKD care involves the provision of evidence-based care to maximize outcomes for patients. Nephrologists must assess patients frequently to determine a number of factors including composition of the dialysate, ultrafiltration rate, dialysis session length, and target weight in order to minimize the risk of hospitalizations and other complications.…”

Section: Fragmentation Of Care As a Barrier Of Optimal Patient-centered Eskd Carementioning

confidence: 99%

“…One example is the use of baclofen, which is contraindicated in ESKD, 25 for spasticity in patients with multiple sclerosis or other neurological disorders. Strategies to facilitate safe ESKD care may involve comprehensive medication review and reconciliation for dialysis patients 26 …”

Section: Introductionmentioning

confidence: 99%

Fragmentation of care as a barrier to optimal ESKD management

Sloan

Zhong

Mohottige

et al. 2020

Seminars in Dialysis

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Caring for patients with end-stage kidney disease (ESKD) in the United States is challenging not only because the epidemiology of the disease's progression is complex, but also because treatment delivery occurs within social and environmental contexts that can be difficult to navigate. Chronic kidney disease (CKD) often results from other conditions, such as hypertension and diabetes. In turn, CKD can contribute to a cascade of new chronic conditions, such as anemia and cardiovascular disease. Notably, 83% of US Medicare fee-for-service program enrollees with CKD have three or more comorbid chronic conditions. 1 As CKD progresses toward ESKD, the number of comorbidities increases, care becomes much more complex and the potential for adverse outcomes increases. 2,3 As a result, care for individuals with ESKD typically involves multiple healthcare providers from multiple subspecialties. In the context of a US healthcare delivery system that has been historically siloed by provider specialty, organization, payment system, and administration,

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“…Understanding the barriers to optimal medication use and implementing evidence-based strategies to optimize regimens for patients on dialysis are expected to improve clinical, humanistic, and economic outcomes. [5][6][7] In this paper, we will explore the complexities of medication use in dialysis and barriers to optimal medication management, including patient-focused, provider-focused, and health-system focused factors, that affect medication use. We will also summarize evidence-based, pragmatic interventions expected to improve medication management in the dialysis setting.…”

Section: Introductionmentioning

confidence: 99%

“…Example of medication therapy problems are described in Table 1. Understanding the barriers to optimal medication use and implementing evidence‐based strategies to optimize regimens for patients on dialysis are expected to improve clinical, humanistic, and economic outcomes 5–7 …”

Section: Introductionmentioning

confidence: 99%

Medication management in dialysis: Barriers and strategies

Cardone

Parker

2020

Seminars in Dialysis

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People with end-stage kidney disease (ESKD) who require chronic dialysis are often reliant on complicated medication regimens to manage their health conditions. Due to the complexities of the advanced kidney disease, underlying comorbidities, and special instructions, medication regimens for patients on dialysis put patients at high risk for medication therapy problems related to safety, effectiveness, appropriateness, and adherence. This article explores the factors that affect optimal medication use for people on dialysis, including the broader drug use system, and offers recommendations around medication reconciliation, medication review, deprescribing, and considering social determinants of health to improve medication management among patients with ESKD.

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Medication Reconciliation: The Foundation of Medication Safety for Patients Requiring Dialysis

Cited by 22 publications

References 31 publications

Effectiveness of Clinical Pharmacist Service on Drug-Related Problems and Patient Outcomes for Hospitalized Patients with Chronic Kidney Disease: A Randomized Controlled Trial

Effectiveness of Clinical Pharmacist Service on Drug-Related Problems and Patient Outcomes for Hospitalized Patients with Chronic Kidney Disease: A Randomized Controlled Trial

Fragmentation of care as a barrier to optimal ESKD management

Medication management in dialysis: Barriers and strategies

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