Sick Day Medication Guidance for People With Diabetes, Kidney Disease, or Cardiovascular Disease: A Systematic Scoping Review

Watson, Kaitlyn E.; Dhaliwal, Kirnvir K.; McMurtry, Ella; Donald, Teagan; Lamont, Nicole; Benterud, Eleanor; Kung, Janice Y.; Robertshaw, Sandra; Verdin, Nancy; Drall, Kelsea M.; Donald, Maoliosa; Campbell, David; McBrien, Kerry; Tsuyuki, Ross T.; Pannu, Neesh; James, Matthew T.

doi:10.1016/j.xkme.2022.100491

Cited by 13 publications

(12 citation statements)

References 24 publications

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“…However, in some admissions, it only became clear at the emergency department of the hospital that the patient had gradually developed symptoms related to AKI or dehydration. This emphasizes the need to focus on educating high-risk patients, whose knowledge about the topic is poor [23], and their carers about the significance of notifying a healthcare provider when a patient develops symptoms, even a minor illness [12,24]. In addition, patient counselling should also involve educating about the risk of dehydration during heatwaves with lifestyle and personalised medication recommendations.…”

Section: Discussionmentioning

confidence: 99%

“…This may be partially explained by the limited knowledge and awareness of primary care providers about the harmful medication effects that can occur when a patient is at risk of dehydration [10,11]. Despite the limited clinical evidence of the effectiveness of sick day medication guidance on patient outcomes [12,13], there is consensus among clinical guideline developers that temporary adjustment of high-risk medication should be considered during periods with a risk of dehydration [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Characteristics and preventability of medication-related admissions for acute kidney injury and dehydration in elderly patients

Coppes,

Hazen,

Zwart

et al. 2024

Eur J Clin Pharmacol

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Purpose Patients with impaired renal function using medication that affects glomerular filtration rate are at increased risk of developing acute kidney injury (AKI) leading to hospital admissions. The risk increases during periods of dehydration due to diarrhoea, vomiting or fever (so-called “sick days”), or high environmental temperatures (heat wave). This study aims to gain insight into the characteristics and preventability of medication-related admissions for AKI and dehydration in elderly patients. Methods Retrospective case series study in patients aged ≥ 65 years with admission for acute kidney injury, dehydration or electrolyte imbalance related to dehydration that was defined as medication-related. General practitioner’s (GP) patient records including medication history and hospital discharge letters were available. For each admission, patient and admission characteristics were collected to review the patient journey. A case-by-case assessment of preventability of hospital admissions was performed. Results In total, 75 admissions were included. Most prevalent comorbidities were hypertension, diabetes, and known impaired renal function. Diuretics and RAS-inhibitors were the most prevalent medication combination. Eighty percent of patients experienced non-acute onset of symptoms and 60% had contacted their GP within 2 weeks prior to admission. Around 40% (n = 29) of admissions were considered potentially preventable if pharmacotherapy had been timely and adequately adjusted. Conclusion A substantial proportion of patients admitted with AKI or dehydration experience non-acute onset of symptoms and had contacted their GP within 2 weeks prior to admission. Timely adjusting of medication in these patients could have potentially prevented a considerable number of admissions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Characteristics and preventability of medication-related admissions for acute kidney injury and dehydration in elderly patients

Coppes,

Hazen,

Zwart

et al. 2024

Eur J Clin Pharmacol

View full text Add to dashboard Cite

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“…However, a recent systematic review highlighted a disparity between the volume of educational resources promoting sick-day guidance and the low number of primary research studies evaluating their usability and effectiveness. To date, there remains 'very little empirical evidence for the effectiveness of current approaches in implementing sick day medication guidance into practice 19 .…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Medication Holds in CKD During Acute Volume-Depleting Illnesses: A Randomized Controlled Trial of a “Sick-Day” Protocol

et al. 2022

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Section: Introductionmentioning

confidence: 99%

“…We conducted a systematic scoping review on this topic and found minimal empiric evidence about the effectiveness of current approaches for the delivery of sick day guidance (SDG). 15 Furthermore, only a few qualitative studies have reported on patients' and HCPs' experiences with interventions for delivering SDG like a ‘medicine sick day guidance’ card, 16 and sick day rule plan. 17 Two other studies have focused solely on patient experiences about self‐care with heart failure during sick days, 18 and a telephone support intervention during sick days 19 Qualitative studies are crucial to effectively capture behaviours, beliefs and experiences 20 —particularly to better understand a complex situation like navigating sick days and managing medications during periods of acute illness.…”

Section: Introductionmentioning

confidence: 99%

Managing ‘sick days’ in patients with chronic conditions: An exploration of patient and healthcare provider experiences

Dhaliwal

Watson

Lamont

et al. 2023

Health Expectations

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Introduction: People with chronic medical conditions often take medications that improve long-term outcomes but which can be harmful during acute illness.Guidelines recommend that healthcare providers offer instructions to temporarily stop these medications when patients are sick (i.e., sick days). We describe the experiences of patients managing sick days and of healthcare providers providing sick day guidance to their patients. Methods:We undertook a qualitative descriptive study. We purposively sampled patients and healthcare providers from across Canada. Adult patients were eligible if they took at least two medications for diabetes, heart disease, high blood pressure and/or kidney disease. Healthcare providers were eligible if they were practising in a community setting with at least 1 year of experience. Data were collected using virtual focus groups and individual phone interviews conducted in English. Team members analyzed transcripts using conventional content analysis. Results:We interviewed 48 participants (20 patients and 28 healthcare providers).Most patients were between 50 and 64 years of age and identified their health

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Sick Day Medication Guidance for People With Diabetes, Kidney Disease, or Cardiovascular Disease: A Systematic Scoping Review

Cited by 13 publications

References 24 publications

Characteristics and preventability of medication-related admissions for acute kidney injury and dehydration in elderly patients

Characteristics and preventability of medication-related admissions for acute kidney injury and dehydration in elderly patients

Medication Holds in CKD During Acute Volume-Depleting Illnesses: A Randomized Controlled Trial of a “Sick-Day” Protocol

Managing ‘sick days’ in patients with chronic conditions: An exploration of patient and healthcare provider experiences

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