A Prospective Observational Study on Medication Use Pattern in Patients With Risk Factors of Chronic Kidney Disease

Abstract

Objectives: The current study was undertaken to review and assess the medication usage pattern in patients with chronic kidney disease (CKD). Methods: A 12-month prospective observational study was carried out at Shadan Teaching and General Hospital, Peerancheru (Hyderabad), involving 384 CKD patients considering the inclusion and exclusion criteria. Medication evaluation for optimization was done using the World Health Organization (WHO) core prescribing indicators. Data collected were entered using Microsoft Excel. Descriptive statistics such as mean, percentage, and standard deviation (SD) were used to present sociodemographic characteristics of the study participants. Results: Out of the total of 384 patients, 249 (65%) were male and 135 (35%) were female with a mean age of 58.28 (SD: 13.12). A total of 384 prescriptions were scrutinized with a total of 3634 drugs, out of which drugs acting on the cardiovascular system were the most prescribed drugs (36.37%). The average number of drugs per prescription was found to be 9.08 considering the total number of prescriptions. The percentage of drugs prescribed by generic name was 15.57%. The percentage of encounters with antibiotics was 25%, whereas the percentage of encounters with injections was 86%. The percentage of drugs prescribed from the Essential Drug List or Formulary was found to be 26.36%. Conclusion: Assessment of medication usage patterns using the WHO core indicators in CKD patients helps to reinforce the current hospital guidelines for the optimal usage of medications. The introduction of a clinical pharmacist along with a multidisciplinary team provides intensive care to the patients and helps to improve the clinical outcome.

Evaluation of Drug Utilization Pattern in Patients with Chronic Kidney Disease

“…In this study, among phosphate binders, 80.9%of selevamer was prescribed to patients while only 19% of calcium acetate was prescribed. These results were similar to study conducted who reported the higher use of selevamer over calcium acetate [24] . Selevamer is non calcium based phosphate binder, which do not possess any risk of coronary calcification.…”

“…Among the diabetic population, insulin (30.7%) was mostly prescribed drug followed by oral hypoglycemic agents amd lipid lowering therapy initiated by prescribing statin (27%) to patients. These findings were supported by findings of a cohort study conducted which found that statin and insulin were prominently prescribed to patients in their management [24] . Insulin can be used in hyperkalemia management and statin used as prophylactic agent to patients who attained 50 years of age or greater than 50 years.…”

“…The average of number of drugs prescribed in the study was 7.6%, which was found to be greater than that reported in a cohort study which found that 6.5%, respectively [20] . About 11.3% of drugs prescribed by generic name, whereas previous study conducted who showed that 15.7% of drugs prescribed by generic name [24] . The wide difference in prescribing pattern of generic drugs and average number of drugs might be due to variation in population, comorbidities and preference of prescriber.…”

Test

“…Avez Ali, et al, reported that male dominance might be due to different hormonal environment [10]. This present study results were similar to results of it [8][9][10] [Table 1].…”

“…Chander Ritesh Kumar et al, reported that the majority of patients were males, the reason can be attributed to smoking, alcohol, obesity, hypertension and hyperlipidemia being more common in males [9]. Avez Ali, et al, reported that male dominance might be due to different hormonal environment [10]. This present study results were similar to results of it [8][9][10] [Table 1].…”