Medication prescribing patterns in ambulatory haemodialysis patients: comparisons of USRDS to a large not-for-profit dialysis provider

Manley, Harold J.; Garvin, Cory G.; Drayer, Debra; Reid, Gerald M.; Bender, Walter L.; Neufeld, Timothy K.; Hebbar, Sudarshan; Muther, Richard S.

doi:10.1093/ndt/gfh280

Cited by 164 publications

(139 citation statements)

References 14 publications

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“…[28][29][30][31] Somewhat counterintuitively, males had less use of statins, a finding at variance with the general population. 32,33 The rate of statin use we found, at 34.2 %, is broadly comparable to that found previous studies 18,34,35 ), and recent work utilizing Medicare Part D (at 44 %), 36 but is much higher than in older studies using data from the late 1990's when rates ranged from about 9-17 %, 15,[37][38][39][40] albeit at 16.6 % in U.S. patients. These rate variations likely reflect temporal trends in statin prescribing which reflect trends in the general population.…”

Section: Discussionsupporting

confidence: 86%

Geographic Variation in HMG-CoA Reductase Inhibitor Use in Dialysis Patients

et al. 2012

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Section: Discussionsupporting

confidence: 86%

Geographic Variation in HMG-CoA Reductase Inhibitor Use in Dialysis Patients

et al. 2012

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“…Most notably, we lacked data on (and therefore could not adjust for) phosphate binder use, which has recently been associated with improved survival in one observational study (49). However, national registry data from this era suggest that the vast majority of HD patients (80 to 88%) were receiving phosphate binders (50), which mitigates to some degree the likelihood that differences in use existed among PDP groups. Finally, considering that these data were obtained in the context of a clinical trial, it is likely that our participants were healthier than the general hemodialysis population.…”

Section: Discussionmentioning

confidence: 99%

Prescribed Dietary Phosphate Restriction and Survival among Hemodialysis Patients

Lynch¹,

Lynch²,

Curhan³

et al. 2011

Clinical Journal of the American Society of Nephrology

130

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SummaryBackground and objectives Hyperphosphatemia is common among hemodialysis patients. Although prescribed dietary phosphate restriction is a recommended therapy, little is known about the long-term effects on survival.Design, setting, participants, & measurements We conducted a post hoc analysis of data from the Hemodialysis Study (n ϭ 1751). Prescribed dietary phosphate was recorded at baseline and annually thereafter. Marginal structural proportional hazard models were fit to estimate the adjusted association between dietary phosphate restriction and mortality in the setting of time-dependent confounding.Results At baseline, prescribed daily phosphate was restricted to levels Յ870, 871 to 999, 1000, 1001 to 2000 mg, and not restricted in 300, 314, 307, 297, and 533 participants, respectively. More restrictive prescribed dietary phosphate was associated with poorer indices of nutritional status on baseline analyses and a persistently greater need for nutritional supplementation but not longitudinal changes in caloric or protein intake. On marginal structural analysis, there was a stepwise trend toward greater survival with more liberal phosphate prescription, which reached statistical significance among subjects prescribed 1001 to 2000 mg/d and those with no specified phosphate restriction: hazard ratios (95% CIs) 0.73 (0.54 to 0.97) and 0.71 (0.55 to 0.92), respectively. Subgroup analysis suggested a more pronounced survival benefit of liberal dietary phosphate prescription among nonblacks, participants without hyperphosphatemia, and those not receiving activated vitamin D.Conclusions Prescribed dietary phosphate restriction is not associated with improved survival among prevalent hemodialysis patients, and increased level of restriction may be associated with greater mortality particularly in some subgroups.

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“…Among all incident maintenance hemodialysis patients in 1993, 34% were prescribed Ն10 different medications, and 8% were prescribed Ն15 different medications (3). A more recent survey of Ͼ10,000 prevalent maintenance hemodialysis patients who were undergoing treatment at Dialysis Clinics Inc. units reported that these patients were prescribed a median of 12 different medications (4). It seems reasonable to suggest that the high daily tablet burden associated with most phosphate binders, superimposed on that associated with other medications, may contribute to poor patient adherence to prescribed dosing (5).…”

mentioning

confidence: 99%

Higher Strength Lanthanum Carbonate Provides Serum Phosphorus Control With a Low Tablet Burden and Is Preferred by Patients and Physicians

Mehrotra

Martin

Fishbane

et al. 2008

Clinical Journal of the American Society of Nephrology

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Results: At the end of week 4, 54% of patients achieved serum phosphorus control at dosages <3000 mg/d administered as one tablet per meal. Among patients who entered cohort B, control rates of 25, 38, and 32% for patients who were randomly assigned to 3000, 3750, or 4500 mg/d lanthanum carbonate, respectively, were achieved, with no increase in adverse events. Patients and physicians reported significantly higher levels of satisfaction with reformulated lanthanum carbonate compared with previous phosphate binders, partly because of reduced tablet burden with higher dosage strengths. Physicians and patients also expressed a preference for lanthanum carbonate over previous medication.Conclusions: Reformulated lanthanum carbonate is an effective phosphate binder that may reduce daily tablet burden.

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Medication prescribing patterns in ambulatory haemodialysis patients: comparisons of USRDS to a large not-for-profit dialysis provider

Cited by 164 publications

References 14 publications

Geographic Variation in HMG-CoA Reductase Inhibitor Use in Dialysis Patients

Geographic Variation in HMG-CoA Reductase Inhibitor Use in Dialysis Patients

Prescribed Dietary Phosphate Restriction and Survival among Hemodialysis Patients

Higher Strength Lanthanum Carbonate Provides Serum Phosphorus Control With a Low Tablet Burden and Is Preferred by Patients and Physicians

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