Drug-related problems in older patients with advanced chronic kidney disease identified during pretransplant comprehensive geriatric assessment

Cerfon, Marie-Anne; Vernaudon, Julien; Gervais, Frédéríc; Morélon, Emmanuel; Coste, Marie-Hélène; Krolak‐Salmon, Pierre; Mouchoux, Christelle; Novais, Teddy

doi:10.1016/j.nephro.2021.08.006

Cited by 2 publications

(4 citation statements)

References 49 publications

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“…In a French investigation of 103 patients with chronic renal disease, 394 DRPs were found in 93.2% of the patients. The comorbidity that arises with aging and the rising number of medications were associated with high risk of DRP in this study [ 21 ].…”

Section: Discussionmentioning

confidence: 98%

“…The average number of DRPs per patient was found to be 0.76 in the present study. This number varies between 0.36 and 3.8 in studies conducted in different countries [ 21 – 25 ]. Although each trial was conducted on CKD patients, the explanation for the disparate outcomes can be attributed to the fact that the number of medicines utilized varied depending on the patient subgroups covered.…”

Section: Discussionmentioning

confidence: 99%

“…Gastrointestinal medications (18.0%), lipid metabolism drugs (13.6%), and antimicrobial drugs (11.7%) ranked 1–3 in the study’s analysis of the drug groups that are associated with DRPs. Compared to literature it is seen that antibiotics and medications for the gastrointestinal system are the two drug classes that most often associated with DRPs in individuals with chronic kidney disease [ 21 , 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

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Impact of a multidisciplinary approach involving clinical pharmacist on resolving drug related problems in chronic kidney patients: a prospective interventional study

et al. 2023

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Background Chronic kidney disease (CKD) is a major public health concern due to its high mortality risk, high hospitalization rates and cost, and low life expectancy. Thus, CKD patients are among patient group that may benefit from clinical pharmacy services the most. Methods This was a prospective interventional study conducted between October 1, 2019, and March 18, 2020, in the nephrology ward of Ankara University School of the Medicine, Ibn-i Sina Hospital. DRPs were classified according to PCNE v8.03. The main outcomes were interventions proposed and the rate of acceptance by the physicians. Results 269 pre-dialysis patients were included to determine DRPs during the treatment process of the patients. 205 DRPs were found in 131 (48.7%) patients. Treatment efficacy was found to be the main type of DRPs (56.2%) followed by treatment safety (39.6%). When patients with and without DRPs were compared, it was found that the number of female patients (55.0%) was higher in the group with DRPs (p < 0.05). The length of hospital stays (11.3 ± 7.7) and the mean number of drugs used (9.6 ± 3.6) in the group with DRPs were significantly higher than those without DRPs (9.3 ± 5.9; 8.1 ± 3.5, respectively) (p < 0.05). 91.7% of the interventions were accepted by the physicians, and patients and found clinically beneficial. 71.7% of DRPs were fully resolved, 1.9% partially resolved and 23.4% could not be resolved. Conclusions A high prevalence of DRPs in patients with chronic kidney disease was determined during therapy. Clinical pharmacist interventions were highly accepted by the physicians and patients. This may indicate implementation of clinical pharmacy services in the nephrology ward has a great impact on optimized therapy and prevention DRPs.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Impact of a multidisciplinary approach involving clinical pharmacist on resolving drug related problems in chronic kidney patients: a prospective interventional study

et al. 2023

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“…According to previous studies, patients with CKD take an average of 8 medications (with polypharmacy prevalence increasing from 80 to 86% between stages 1 and 3 of CKD), while dialysis patients take 10 to 12 medications per day [ 7 , 8 ]. A patient with advanced kidney disease may be more susceptible to drug-related problems (DRPs) associated with polypharmacy and changes in pharmacokinetics and pharmacodynamics [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Determination of drug-related problems according to PAIR criteria in dialysis patients: a cross-sectional study in tertiary care hospital

Pehlivanli,

Akkan Eren,

Sengul

et al. 2024

BMC Pharmacol Toxicol

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Background Dialysis patients are at high risk for drug-related problems (DRPs), which have significant consequences for their morbidity, mortality, and quality of life. Improved clinical outcomes can be achieved by preventing, identifying, and resolving these problems. Methods This is a retrospective observational study. In this study, the PAIR instrument (Pharmacotherapy Assessment in Chronic Renal Disease) was validated for use in Turkish. Validation consisted of three stages: translation back-translation with expert panel evaluation, reliability analysis using the test-retest method, and conceptual validity with both Pharmaceutical Care Network Europe (PCNE) and PAIR used to determine DRPs prevalence. Results In total, 104 patients (mean ± SD age, 54.1 ± 15.8 years; 53.8% male) were included in the study. An expert panel evaluated the items in the criterion based on their intelligibility, service of purpose, differentiation, and cultural suitability during the translation stage. Content validity index (CVI) score was found to be 0.95. The reliability analysis was performed by applying the test-retest method and calculating correlation coefficient on 30 randomly selected patients one month later. Correlation coefficient (p) was found to be 0.8. To evaluate conceptual validity, 104 patients’ pharmacotherapy plans were assessed using both the PAIR and PCNE criteria. The prevalence of DRPs according to PAIR criteria (100.0%) and PCNE (73.1%) were statistically significantly different (p < 0.001). Conclusions As a result, PAIR criteria can identify clinically relevant DRPs in patients with CKD and is a new, validated tool to be used in Turkey, but may not be adequate for patients receiving dialysis. Therefore, it needs to be reviewed and updated for dialysis patients.

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Drug-related problems in older patients with advanced chronic kidney disease identified during pretransplant comprehensive geriatric assessment

Cited by 2 publications

References 49 publications

Impact of a multidisciplinary approach involving clinical pharmacist on resolving drug related problems in chronic kidney patients: a prospective interventional study

Impact of a multidisciplinary approach involving clinical pharmacist on resolving drug related problems in chronic kidney patients: a prospective interventional study

Determination of drug-related problems according to PAIR criteria in dialysis patients: a cross-sectional study in tertiary care hospital

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