Prescribing patterns of medicines in chronic kidney disease patients on maintenance hemodialysis

Chakraborty, Sourav; Ghosh, Saugata; Banerjea, Avishek; De, Radha Raman; Hazra, Avijit; Mandal, Sushil Kumar

doi:10.4103/0253-7613.190760

Cited by 27 publications

(38 citation statements)

References 23 publications

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“…Therefore, the literature has often documented a high prevalence of polypharmacy in patients with CKD and musculoskeletal conditions. [23][24][25][26] Nevertheless, future research may be warranted to further examine the differences in polypharmacy and inappropriate medication use across various types of chronic conditions or combinations among different populations.…”

Section: Discussionmentioning

confidence: 99%

Polypharmacy and Multimorbidity Among Medicaid Enrollees: A Multistate Analysis

Feng

Tan

Riley

et al. 2018

Population Health Management

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The purpose of this study is to explore the associations between polypharmacy and multimorbidity using conventional and novel measures of polypharmacy. In this cross-sectional study, data on fee-for-service (FFS) Medicaid enrollees with at least 1 chronic condition and aged 18-64 years (N = 38,329) were derived from the 2010 Medicaid Analytic eXtract (MAX) files of Maryland and West Virginia. Polypharmacy, by the authors' novel definition, was determined as simultaneous use of ≥5 drugs for a consecutive period of 60 days. Multimorbidity was defined as having ≥2 chronic conditions based on the US Department of Health and Human Services framework. The association between multimorbidity and polypharmacy was examined with chi-square tests and logistic regression. Polypharmacy prevalence was estimated at 50.9% using the novel definition, as compared to 16.7% and 64.9% for the 2 commonly used conventional measures, respectively. For all 3 definitions, individuals with multimorbidity were more likely to have polypharmacy than those without multimorbidity (P < 0.001). The authors also consistently found, using all definitions, that those who were older, female, white, and eligible for Medicaid because of cash assistance were more likely to have polypharmacy (all P < 0.001). Polypharmacy was highly prevalent and significantly associated with multimorbidity among Medicaid FFS enrollees irrespective of the definitions used. The new measure may provide a more comprehensive and accurate estimation of polypharmacy than the conventional measures. These findings suggest the need for a paradigm shift from disease-specific care to patient-centered collaborative care to manage patients with multimorbidity and polypharmacy.

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Section: Discussionmentioning

confidence: 99%

Polypharmacy and Multimorbidity Among Medicaid Enrollees: A Multistate Analysis

Feng

Tan

Riley

et al. 2018

Population Health Management

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“…[ 2 ] The reason for India becoming a leading reservoir of CKD can be attributed to the growing prevalence of diabetes and hypertension. [ 3 ] In the early stages of CKD, the treatment is essential only for the causal conditions (diabetes, hypertension, and other primary risk factors) and to alleviate the advancement of CKD. However, as kidney function deteriorates, a number of medications are administered to manage associated conditions such as mineral and bone disorders, anemia, hyperlipidemia, and cardiovascular complications.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of prescribing practices and drug-related problems in chronic kidney disease patients: A cross-sectional study

et al. 2020

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Aim: The primary intent of the study is to analyze the prescribing pattern and to identify the various drug-related problems (DRPs) associated with the therapy in chronic kidney disease (CKD) patients. Subjects and Methods: A prospective observational study was conducted in 160 patients diagnosed with any stages of CKD. The prescribing pattern was studied and DRPs were identified, reported, and categorized as per the Pharmaceutical Care Network Europe classification V 5.01. The association between categorical variables was analyzed using the Chi-square test. The predictors of DRPs were identified using binary logistic regression analysis. Results: The mean age of the study population was 50.08 ± 15.32 years with male predominance (71%). The average number of drugs per prescription was found to be 9.16 ± 3.01. The most prescribed drug category was antihypertensives and the most commonly prescribed drugs were diuretics. A total of 337 DRPs were identified, out of which the most common DRP was drug interactions (60%), followed by frequency errors (11.6%). Logistic regression analysis identified comorbidities more than three (odds ratio 2.09), antihypertensives more than two (odds ratio 1.9), alcoholism (odds ratio 1.5), and polypharmacy (odds ratio 1.2) as the predictors of DRPs even though they were not statistically significant at P = 0.01. Conclusion: DRPs increase the risk of deterioration of the disease state and increase the length of hospital stay. Identification and resolving of the DRPs will lead to better patient care and proper treatment. Early identification and modification of the above-mentioned predictors could possibly prevent/reduce DRPs.

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“…ESRD is a chronic disease that affects many people all over the world and is associated with high morbidity and mortality [7]. ESRD patients on maintenance haemodialysis, have co morbidities that require multiple medications which may lead to poor adherence [8].…”

Section: Discussionmentioning

confidence: 99%

Impact of Pharmacist Intervention on Medication Knowledge and Adherence in Hemodialysis Patients

Rodrigues¹,

Saji²,

Raj³

et al. 2019

Int J Pharm Pharm Sci

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Objective: The objectives of the study are to evaluate the medication knowledge and medication adherence in patients undergoing haemodialysis and to educate the patients regarding the importance of medication adherence through counseling by providing Patient Information Leaflets and to analyze its impact. Methods: 50 Patients were randomly divided into two groups (control and test). Patient data was collected and documented using the patient data collection form after obtaining their consent. Their knowledge and medication adherence were assessed using questionnaires and was quantified. Patients included in the test group were counseled using Patient Information Leaflets whereas the control group was not counseled. Re-assessment was done during follow up for both groups. Results: Paired t-test was done to check if there was a significant difference in both the test and control group, with and without the use of Patient Information Leaflets respectively. The study showed that the test group had significant improvement (P<0.05) in their medication adherence and knowledge whereas there was no significant change in the control group. Conclusion: Providing patient counseling and continuous education with efforts to improve awareness among haemodialysis patients could enhance adherence to therapies and thus could improve clinical outcomes and quality of life.

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Prescribing patterns of medicines in chronic kidney disease patients on maintenance hemodialysis

Cited by 27 publications

References 23 publications

Polypharmacy and Multimorbidity Among Medicaid Enrollees: A Multistate Analysis

Polypharmacy and Multimorbidity Among Medicaid Enrollees: A Multistate Analysis

Evaluation of prescribing practices and drug-related problems in chronic kidney disease patients: A cross-sectional study

Impact of Pharmacist Intervention on Medication Knowledge and Adherence in Hemodialysis Patients

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