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Quantifying home medication regimen changes and quality of life in patients receiving nocturnal home hemodialysis

Medication regimen simplification may improve adherence in end‐stage kidney disease. The effect of nocturnal home hemodialysis (NHHD) on medication burden is unknown. A retrospective pilot study of NHHD patients was conducted. Medication information was collected at baseline, NHHD start, and at 3, 6...

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Published in:Hemodialysis international 2011-04, Vol.15 (2), p.234-242
Main Authors: CARDONE, Katie E., MANLEY, Harold J., GRABE, Darren W., MEOLA, Shari, HOY, Christopher D., BAILIE, George R.
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container_title Hemodialysis international
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MANLEY, Harold J.
GRABE, Darren W.
MEOLA, Shari
HOY, Christopher D.
BAILIE, George R.
description Medication regimen simplification may improve adherence in end‐stage kidney disease. The effect of nocturnal home hemodialysis (NHHD) on medication burden is unknown. A retrospective pilot study of NHHD patients was conducted. Medication information was collected at baseline, NHHD start, and at 3, 6, 12, 18, and 24 months. SF‐36 scores were collected at baseline, 6, 12, and 24 months. The number of medications, pill burden, and number of administrations per day were determined. Medication Regimen Complexity Index was used at each time point as a comparator. Medications for anemia, mineral and bone disorders (MBD), cardiovascular (CV) disease, infection, and vitamins were analyzed for number of medications and pill burden. Thirty‐five patients were included. Patients used 10.5 ± 4.4 medications at baseline and 11.8 ± 4.7 at the end of the study (P=NS). Regarding the number of medications, anemia medications, anti‐infectives, and vitamins increased; MBD and CV medications decreased by the end of the study. Total pill burden did not change over 24 months, nor did anemia pill burden. Mineral bone disorder and CV pill burden decreased, and vitamins and anti‐infective pill burden increased. Daily medication administration times decreased significantly from 5.0 ± 1.5 to 3.6 ± 1.5 by 24 months. Switching to NHHD was associated with a significant increase in Medication Regimen Complexity Index at 24 months (P
doi_str_mv 10.1111/j.1542-4758.2011.00539.x
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The effect of nocturnal home hemodialysis (NHHD) on medication burden is unknown. A retrospective pilot study of NHHD patients was conducted. Medication information was collected at baseline, NHHD start, and at 3, 6, 12, 18, and 24 months. SF‐36 scores were collected at baseline, 6, 12, and 24 months. The number of medications, pill burden, and number of administrations per day were determined. Medication Regimen Complexity Index was used at each time point as a comparator. Medications for anemia, mineral and bone disorders (MBD), cardiovascular (CV) disease, infection, and vitamins were analyzed for number of medications and pill burden. Thirty‐five patients were included. Patients used 10.5 ± 4.4 medications at baseline and 11.8 ± 4.7 at the end of the study (P=NS). Regarding the number of medications, anemia medications, anti‐infectives, and vitamins increased; MBD and CV medications decreased by the end of the study. Total pill burden did not change over 24 months, nor did anemia pill burden. Mineral bone disorder and CV pill burden decreased, and vitamins and anti‐infective pill burden increased. Daily medication administration times decreased significantly from 5.0 ± 1.5 to 3.6 ± 1.5 by 24 months. Switching to NHHD was associated with a significant increase in Medication Regimen Complexity Index at 24 months (P&lt;0.05). SF‐36 scores increased significantly once patients began on NHHD. No measure of medication regimen complexity was correlated with the SF‐36 score. Medication burden changes over time after starting NHHD. 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subjects Adherence
Drug Administration Schedule
Female
Hemodialysis, Home - methods
Hemodialysis, Home - standards
Humans
Kidney Failure, Chronic - drug therapy
Kidney Failure, Chronic - therapy
Male
Medication Adherence
medication regimen
Middle Aged
nocturnal home hemodialysis
pill burden
Practice Guidelines as Topic
Quality of Life
Retrospective Studies
Time Factors
title Quantifying home medication regimen changes and quality of life in patients receiving nocturnal home hemodialysis
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