Drug utilization pattern among patients of chronic renal failure on maintenance hemodialysis in a tertiary care teaching hospital

Abstract

Background: In India, end-stage renal disease incidence is 100 patients/million population/year, which means every year for a population of 1 billion almost more than 100,000 new patients will occur. Nowadays, the prevalence of chronic kidney disease (CKD) is augmenting due to the advancement of age, polypharmacy, and drug interactions. Drug utilization studies determine the rational prescription of drugs. Aim and Objectives: The aims of this study were to determine the drug utilization pattern among CKD patients who were on maintenance hemodialysis and to identify the comorbidities among them. Materials and Methods: After obtaining approval from the Institutional Ethics Committee a prospective, observational study was conducted by the Department of Pharmacology, Guntur Medical College, Guntur, from January to June 2022. The details of demographic, biochemical, clinical data, and drugs prescribed in CKD patients undergoing maintenance hemodialysis were recorded in a structured case report form. To analyze the data, descriptive statistics were used. Results: Among 100 patients evaluated, males and females were 72 and 28, respectively. Their mean ages were 47.55 ± 11.49 years and 39.82 ± 13.56 years, respectively. The majority of the patients received hematinics followed by multivitamins, anti-hypertensives, drugs used in gastrointestinal disorders, antioxidants, respiratory drugs, CNS drugs, diuretics, and antibiotics. The most common comorbidity was hypertension followed by diabetes, epilepsy, tuberculosis, and HIV. Among the prescribed drugs, 74% were from the Indian national list of essential medicine and only 3% were by generic name. About 74% of patients received five or more drugs. Conclusion: This study describes the pattern of drug utilization in CKD patients undergoing maintenance hemodialysis. As polypharmacy is more prevalent, among them elements such as adverse drug reactions and adherence to therapy must be investigated further to minimize drug interactions and to improve patient quality life.