Pharmacists’ strategies to detect, resolve, and prevent DRPs in CKD patients

Susilawati, Ni Made; Halimah, Eli; Saidah, Siti

doi:10.3897/pharmacia.68.e65136

Cited by 4 publications

(3 citation statements)

References 31 publications

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“…14 There are many studies conducted in patients with other clinical conditions that reported the frequency of DRPs either equal or different than our findings. 19,20 These differences are mostly due to the variation in the sample size, study design, age of the study population, extent of involvement by clinical pharmacist, polypharmacy and presence of other co-morbid conditions.…”

Section: Discussionmentioning

confidence: 99%

Frequency and risk factors for the development of drug related problems among rheumatoid arthritis patients

Sah

Subramanian

Ramesh

2022

Clinical Epidemiology and Global Health

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Background: Rheumatoid arthritis (RA) patients are at high risk for development of drug related problems (DRPs) due to multiple drug use. This study aimed to estimate the frequency and risk factors for the development of drug related problems among RA patients in Indian setting. Methods: A prospective cohort study was carried out for twenty-two months in a tertiary care teaching hospital. Patients who met study eligibility criteria were randomised either into intervention or usual care group. All the patients' data were screened for the presence of DRPs. Identified DRPs were categorized into problems and their causes using Pharmaceutical Care Network Europe (PCNE V8.02) DRP Classification system. Clinical pharmacists proposed interventions to resolve DRPs in intervention group. Results: A total of 320 RA patients [Intervention group, n = 160 and usual care group, n = 160] were enrolled in this study. Overall, 463 DRPs were identified among 88.4% of patients, and frequency of DRPs was 1.6 per patient. Treatment safety (41.2%) and patient related factors (28.2%) was the most common category and cause of DRPs respectively. Advanced age and polypharmacy were the common risk factors identified for the development of DRPs. Conclusion: This study revealed DRPs are common among RA patients and those are related to the treatment safety and efficacy. Clinical pharmacists' provided interventions had significant impact on DRPs resolution among RA patients.

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Section: Discussionmentioning

confidence: 99%

Frequency and risk factors for the development of drug related problems among rheumatoid arthritis patients

Sah

Subramanian

Ramesh

2022

Clinical Epidemiology and Global Health

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“…Chronic kidney disease (CKD) stands as a formidable global public health challenge, demanding timely identification and intervention to impede its progression [1][2][3][4][5]. Upon reaching the critical stage culminating in end-stage renal disease (ESRD), patients confront the necessity for kidney replacement therapies (KRT), encompassing hemodialysis (HD), peritoneal dialysis (PD), and kidney transplant (KT) [1,5].…”

Section: Introductionmentioning

confidence: 99%

Factors Contributing to Negative Outcomes Associated with Medications and Drug-Related Problems in Kidney Replacement Therapy—A Hospital-Based Prospective Observational Study

Pereira-Céspedes,

Jiménez-Morales,

Polo-Moyano

et al. 2024

JCM

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Background: Negative outcomes associated with medications (NOM) and drug-related problems (DRP) significantly impact individuals with kidney replacement therapy (KRT) given the complexities of managing kidney disease and associated comorbidities. The present study aims to assess the frequency of NOMs/DRPs among KRT patients and identify contributing factors. Methods: A cross-sectional study was conducted at Virgen de las Nieves University Hospital (Granada, Spain), involving 117 outpatient adults with KRT. Data were collected from February 2021 to July 2023 using electronic records, semi-structured interviews (Dáder Method), and discussions with nephrology specialists. NOMs/DRPs were identified following treatment guidelines. Binary logistic regression was used to determine associated factors (p-value < 0.05). Results: Across 117 patients, 2436 NOMs and 3303 DRPs were identified, averaging 20.82 NOMs and 28.23 DRPs per patient. Prevalent NOMs included untreated conditions (58.95%), quantitative ineffectiveness (35.43%), and non-quantitative safety problems (5.13%). Dominant DRPs were undertreated conditions (37.63%), wrong dose/posology/length (33.00%), risk of adverse drug reactions (ADR) (16.14%), and non-adherence (6.87%). Patients with ADR, undertreated conditions, and anemia were associated with quantitative ineffectiveness. Risk of ADR and vitamin D deficiency/insufficiency correlated with non-quantitative safety problems. Conclusions: KRT patients exhibited a substantial prevalence of NOMs/DRPs. Further research is needed to deepen our understanding of these complexities for improved patient care.

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“…Early detection and prevention of DRPs among patients with kidney dysfunction in developed countries has been made possible by the incorporation of clinical pharmacy services and the application of evidence-based guidelines [ 18 , 19 ]. This has led to a comprehensive and interdisciplinary approach to identify, prevent and manage DRPs in these patients [ 19 , 20 ]. In particular, pharmacist-led interventions have successfully identified and resolved DRPs in patients with kidney dysfunction [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Drug-related problems and associated factors among patients with kidney dysfunction at a tertiary hospital in southwestern Uganda: a prospective observational study

Kyomya,

Atwiine,

Shegena

et al. 2023

BMC Nephrol

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Background Kidney dysfunction is a common, progressive condition that is increasingly becoming a global public health issue. Because the kidneys are the major route for drug excretion, impaired renal function can change the pharmacokinetics and pharmacodynamics of drugs that are renally excreted. Additionally, patients with kidney dysfunction often have co-morbidities and the associated use of multiple medications which increases the risk of drug-related problem (DRP) occurrence. This study aimed to determine the prevalence, types, and factors associated with DRPs in patients with kidney dysfunction. Method We conducted a prospective observational study over 3 months among hospitalized patients diagnosed with acute kidney injury or chronic kidney disease who were hospitalized in the medical ward, and patients attending the renal outpatient clinic at Mbarara Regional Referral Hospital. A total of 183 participants were enrolled through the use of a consecutive sampling technique. DRPs were classified according to the PCNE classification version 9.1. Data analysis was carried out using SPSS version 25. Results A total of 174 patients with kidney dysfunction were included in the study with a mean ± SD age of 50.34 ± 18.13 years. A total of 219 DRPs were incurred by 138 (79.3%) study participants. The most common DRPs were ‘Untreated symptoms or indication’ (35.6%) followed by ‘adverse event (possibly) occurring’ (28.3%), and ‘effect of drug treatment not optimal’ (23.3%). Antimicrobials were the most involved drugs in suboptimal drug treatment (31.3%) and unnecessary drug treatment (32.1%). The study showed that length of hospital stay ≥ 5 days (AOR = 6.39, 95% CI: 1.75–23.27; p-value = 0.005) significantly increased the risk of DRP occurrence. Conclusion The current results, in agreement with previous literature, showed a high burden of DRPs among patients with kidney dysfunction. Antimicrobials were the most involved drugs in suboptimal as well as in unnecessary drug treatment. Longer hospital stay significantly increased the risk of DRPs. The high prevalence of DRPs in patients with kidney dysfunction and the potential impact on antimicrobial resistance underscores the importance of regular medication reviews and close monitoring of patients with renal dysfunction.

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Pharmacists’ strategies to detect, resolve, and prevent DRPs in CKD patients

Cited by 4 publications

References 31 publications

Frequency and risk factors for the development of drug related problems among rheumatoid arthritis patients

Frequency and risk factors for the development of drug related problems among rheumatoid arthritis patients

Factors Contributing to Negative Outcomes Associated with Medications and Drug-Related Problems in Kidney Replacement Therapy—A Hospital-Based Prospective Observational Study

Drug-related problems and associated factors among patients with kidney dysfunction at a tertiary hospital in southwestern Uganda: a prospective observational study

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