Prescribing patterns of medicines in chronic kidney disease patients on maintenance hemodialysis

• Published in: Indian journal of pharmacology 2016-09, Vol.48 (5), p.586-590
• Main Authors: Chakraborty, Sourav, Ghosh, Saugata, Banerjea, Avishek, De, Radha, Hazra, Avijit, Mandal, Swapan
• Format: Article
• Language: English
• Subjects: Adult; Chronic illnesses; Chronic kidney failure; Drug Interactions; Drug therapy; Drug-Related Side Effects and Adverse Reactions - epidemiology; Female; Hemodialysis; Hospitals, Teaching; Humans; Incidence; Kidney diseases; Male; Medication Adherence; Methods; Middle Aged; Polypharmacy; Practice Patterns, Physicians; Prescription writing; Renal Dialysis; Renal Insufficiency, Chronic - drug therapy; Renal Insufficiency, Chronic - therapy; Short Communication; Statistics; Studies
• ISSN: 0253-7613; 1998-3751
• DOI: 10.4103/0253-7613.190760

Objectives: To study medicine prescribing pattern for chronic kidney disease (CKD) patients on maintenance hemodialysis. Materials and Methods: This prospective observational study was conducted in hemodialysis unit of a teaching hospital with adult CKD patients on maintenance hemodialysis. Patients′ clinical profile, drug-use pattern, and medication-related problem data were captured in a structured case report form and the data were analyzed descriptively. Adherence level was assessed by Morisky Medication-Taking Adherence Scale 4-item. Results: Data from 100 patients recruited over 6 months have been analyzed. The median (interquartile range [IQR]) age was 51 (42-57) years; 57% were male, mean [standard deviation (SD)] urea level was 160.11 (70.32) mg/dL, mean (SD) creatinine level was 8.73 (5.29) mg/dL. A large number (46%) were suffering from diabetic nephropathy. The common comorbidities were anemia (89%) followed by hypertension (85%). The median (IQR) number of drugs per prescription was 10 (9-13), with the bulk being cardiovascular drugs (23.41%) followed by gastrointestinal drugs (15.76%) and vitamins (12.29%). The median (IQR) number of potential drug-drug interaction per prescription was 2 (2-3). The incidence of adverse drug reactions (ADRs) was 46% with hyponatremia being most common (32%), followed by hypoglycemia (16%) and hypokalemia (10%). Adherence level was low in the majority (64%) of patients. Conclusions: There is a high incidence of polypharmacy along with significant medication-related problems such as high drug-drug interactions/prescription, high incidence of ADRs, and low adherence.