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Identification of drug-related problems in ambulatory chronic kidney disease patients: a 6-month prospective study.

Abstract：

BACKGROUND:Drug-related problems (DRPs) are common in chronic kidney disease (CKD) patients. We developed a 2-step consultation including a clinical pharmacist (CP) session and a nephrologist conventional care consultation to explore the feasibility of a pilot drug-oriented disease management program in controlling iatrogenic side effects. METHODS:Drug inventory was estimated by a CP before each nephrology consultation. CP interventions were based on the French Society of Clinical Pharmacy intervention tools. RESULTS:In this 6-month prospective study, 67 CKD patients were enrolled: 77% with stage 3 or 4 CKD (by Kidney Disease Improving Global Outcomes criteria), 66% males, 76% with diabetes, median age 70 years (range 59-75), with a mean 2.6 ± 1.2 comorbidities and 10 ± 3.5 medications. We registered 142 DRPs, in 93% of patients, which mainly concerned untreated indications (31.7%) and incorrect dosages (19%). The most frequent pharmaceutical interventions concerned addition of drug (34%) and adaptation of dose (25.5%). The main drugs involved concerned the cardiovascular (33%), digestive-metabolic (26.9%) and hematopoietic (19.9%) systems. DRPs correlated significantly with a higher number of medications (p=0.049) and with older patient age (p=0.0027). Furthermore, patients' knowledge was evaluated in 41 patients (61%) by the CP with a systematic questionnaire. Three at-risk situations were described: 80.5% of patients interviewed were unaware of the beneficial impact of their treatment, 85% were not aware of medical situations at risk and 68% declared self-medication habits. CONCLUSION:A formatted CP evaluation coupled with a renal consultation was able to detect a higher level of DRPs, to reinforce educational messages and to propose immediate changes in the therapeutic project.

journal_name

J Nephrol

journal_title

Journal of nephrology

authors

Belaiche S,Romanet T,Allenet B,Calop J,Zaoui P

doi

10.5301/jn.5000063

subject

Has Abstract

pub_date

2012-09-01 00:00:00

pages

782-8

issue

5

eissn

1121-8428

issn

1724-6059

pii

97AC4B83-7A18-4273-8698-7B372EBA3188

journal_volume

25

pub_type

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