Literature DB >> 12552501

Factors associated with medication-related problems in ambulatory hemodialysis patients.

Harold J Manley1, Marcy L McClaran, Debra K Overbay, Marcia A Wright, Gerald M Reid, Walter L Bender, Timothy K Neufeld, Sudarshan Hebbar, Richard S Muther.   

Abstract

BACKGROUND: Hemodialysis (HD) patients are at risk for medication-related problems. Patient characteristics associated with the number of medication-related problems in HD patients have not been investigated.
METHODS: Patient records were reviewed to identify medical problems, prescribed medications, medication indication(s), and medication-related problems. Medication classes and medication-related problems were compared between patients with and without diabetes mellitus (DM). Correlations were performed to determine whether associations exist between medication-related problems, number of medications, number of medication doses per day, number of comorbid conditions, patient age, and duration of end-stage renal disease while controlling for DM status.
RESULTS: Medical records of 133 patients were evaluated. Patients were 60.5 +/- 15.2 years old, prescribed 11.0 +/- 4.2 medications, and had 6.0 +/- 2.3 comorbidities. Medication-related problems were identified in 97.7% of patients. Four hundred seventy-five medication-related problems were identified, averaging 3.6 +/- 1.8 medication-related problems per patient. Patients with DM had more medication-related problems identified than those without DM (303 versus 172 medication-related problems, respectively; P < 0.05). Medication-related problems correlated positively with number of patient comorbidities (P < 0.001).
CONCLUSION: Medication-related problems are prevalent in virtually all HD patients. The number of medication-related problems in an individual patient increases as the number of comorbid conditions increases. The most frequent medication-related problems were drug without indication (30.9%), laboratory (27.6%), indication without drug use (17.5%), and dosing errors (15.4%). Patients with DM are at increased risk for medication-related problems. Health care providers taking care of HD patients should be aware of this problem, and efforts to avoid or resolve medication-related problems should be undertaken at all HD clinics. Copyright 2003 by the National Kidney Foundation, Inc.

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Year:  2003        PMID: 12552501     DOI: 10.1053/ajkd.2003.50048

Source DB:  PubMed          Journal:  Am J Kidney Dis        ISSN: 0272-6386            Impact factor:   8.860


  22 in total

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