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Prevalence of medication-related problems among patients with renal compromise in an Indian hospital

Citation

Castelino, RL and Sathvik, BS and Parthasarathi, G and Gurudev, KC and Shetty, MS and Narahari, MG, Prevalence of medication-related problems among patients with renal compromise in an Indian hospital, Journal of Clinical Pharmacy and Therapeutics, 36 pp. 481-487. ISSN 0269-4727 (2011) [Refereed Article]

Copyright Statement

Copyright 2011 Blackwell

DOI: doi:10.1111/j.1365-2710.2011.01266.x

Abstract

What is known and Objective: Patients suffering from renal dysfunction often have multiple medical conditions either as a cause or as a consequence of their renal disease. These patients receive an average of 10–12 medications daily leading to complex dosing schedules and are more likely to develop medication-related problems (MRPs). The objectives of this study were to determine the nature and extent of MRPs in renally compromised patients and to explore the potential clinical significance of the MRPs. The potential for a clinical pharmacist to contribute towards resolving or preventing some of these MRPs was also explored. Methods: A prospective study was conducted for a period of 9 months in the renal unit of Jagadguru Shri Shivaratheeshwara (JSS) Medical College Hospital, Mysore, India. Patients undergoing dialysis on outpatient basis and patients who were admitted under the care of or referred to the nephrologists for renal dysfunction from other specialties were reviewed. Patterns of the MRPs were identified using an adapted Hepler and Strand criteria. The potential clinical significance of the MRPs and the contribution of the clinical pharmacist in resolving or minimizing some of the MRPs were also explored. Results and Discussion: Three hundred and twenty-seven MRPs were identified with 308 patients reviewed. The incidence of MRPs was found to be 1Ć06 ± 0Ć85 per patient reviewed. The most common MRP identified in our study was overdose (19Ć3%) followed by adverse drug reactions (19Ć0%). Cardiovascular agents (33Ć6%) followed by anti-infective agents (26Ć3%) were the most common therapeutic classes of medication implicated in causing MRPs. Twenty-six per cent of the MRPs identified were explored to be potentially moderate or major in clinical significance. The clinical pharmacists’ recommendations were accepted in 97% of the cases, which resulted in a change in therapy in 83% of the cases. What is new and Conclusion: Medication-related problems are frequent in renally compromised patients in our patient population. The high level of acceptance of clinical pharmacist’s recommendations by the nephrologists demonstrates that clinical pharmacists may help improve overall patient care in this setting.

Item Details

Item Type:Refereed Article
Keywords:clincical pharmacy, medication-related problems, renal impairment
Research Division:Medical and Health Sciences
Research Group:Pharmacology and Pharmaceutical Sciences
Research Field:Clinical Pharmacy and Pharmacy Practice
Objective Division:Health
Objective Group:Other Health
Objective Field:Health not elsewhere classified
Author:Castelino, RL (Dr Ronald Castelino)
ID Code:86275
Year Published:2011
Web of Science® Times Cited:8
Deposited By:Pharmacy
Deposited On:2013-09-02
Last Modified:2017-04-26
Downloads:0

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