Medication-related problem type and appearance rate in ambulatory hemodialysis patients

被引：43

作者：

Harold J Manley

Debra K Drayer

Richard S Muther

机构：

[1] Univ. MO-Kansas City Sch. of Pharm., Kansas City, MO

[2] Dialysis Clinic, Inc., Kansas City, MO

[3] Kidney Associates of Kansas City, Kansas City, MO

来源：

BMC Nephrology | / 4卷 / 1期

关键词：

Pharmaceutical Care; Previous Myocardial Infarction; Sevelamer; Inappropriate Medication; Appearance Rate;

D O I：

10.1186/1471-2369-4-10

中图分类号：

学科分类号：

摘要：

Background: Hemodialysis (HD) patients are at risk for medication-related problems (MRP). The MRP number, type, and appearance rate over time in ambulatory HD patients has not been investigated. Methods: Randomly selected HD patients were enrolled to receive monthly pharmaceutical care visits. At each visit, MRP were identified through review of the patient chart, electronic medical record, patient interview, and communications with other healthcare disciplines. All MRP were categorized by type and medication class. MRP appearance rate was determined as the number of MRP identified per month/number of months in study. The number of MRP per patient-drug exposures were determined using: {[(number of patients) × (mean number of medications)]/(number of months of study)} /number of MRP identified. Results were expressed as mean ± standard deviation or percentages. Results: Patients were 62.6 ± 15.9 years old, had 6.4 ± 2.0 comorbid conditions, were taking 12.5 ± 4.2 medications, and 15.7 ± 7.2 doses per day at baseline. Medication-dosing problems (33.5%), adverse drug reactions (20.7%), and an indication that was not currently being treated (13.5%) were the most common MRP. 5,373 medication orders were reviewed and a MRP was identified every 15.2 medication exposures. Overall MRP appearance rate was 0.68 ± 0.46 per patient per month. Conclusion: MRP continue to occur at a high rate in ambulatory HD patients. Healthcare providers taking care of HD patients should be aware of this problem and efforts to avoid or resolve MRP should be undertaken at all HD clinics.

引用

页码：1 / 7

页数：6

共 25 条

[1]

Kohn L.T., Corrigan J.M., Donaldson M.S., To Err is Human: Building a Safer Health System, (1999)

[2]

Ernst F.R., Grizzle A.J., Drug-related morbidity and mortality: Updating the cost-of-illness model, J Am Pharm Assoc(Wash), 41, 2, pp. 192-199, (2001)

[3]

Lazarou J., Pomeranz B.H., Corey P.N., Incidence of adverse drug reactions in hospitalized patients: A meta-analysis of prospective studies, JAMA, 279, pp. 1200-1205, (1998)

[4]

Nelson K.M., Talbert R.L., Drug-related hospital admissions, Pharmacotherapy, 16, 4, pp. 701-707, (1996)

[5]

Ebbesen J., Buajordet I., Erikssen J., Brors O., Hilberg J., Svaar H., Sandvik L., Drug-related deaths in a department of internal medicine, Arch Intern Med, 161, pp. 2317-2323, (2001)

[6]

Gandhi T.K., Weingart S.N., Borus J., Seger A.C., Peterson J., Burdick E., Segen D.L., Shu K., Federico F., Leape L.L., Bates D.W., Adverse drug events in ambulatory care, N Engl J Med, 348, 16, pp. 1556-1564, (2003)

[7]

USRDS 2002 Annual Data Report: Atlas of End-Stage Renal Disease in the United States National Institutes of Health, (2002)

[8]

Hepler C.D., Strand L.M., Opportunities and responsibilities in pharmaceutical care, Am J Hosp Pharm, 47, pp. 533-543, (1990)

[9]

Leape L.L., Cullen D.J., Clapp M.D., Burdick E., Demonaco H.J., Erickson J.I., Bates D.W., Pharmacist participation on physician rounds and adverse drug events in the intensive care unit, JAMA, 282, pp. 267-270, (1999)

[10]

Gattis W.A., Hasselblad V., Whellan D.J., O'Connor C.M., Reduction in heart failure events by the addition of a clinical pharmacist to the heart failure management team: Results of the Pharmacist in Heart Failure Assessment Recommendation and Monitoring (PHARM) Study, Arch Intern Med, 159, pp. 1939-1945, (1999)

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