Evaluation of prescribing practices and drug-related problems in chronic kidney disease patients: A cross-sectional study

Perspect Clin Res. 2020 Apr-Jun;11(2):70-74. doi: 10.4103/picr.PICR_110_18. Epub 2020 May 6.

Abstract

Aim: The primary intent of the study is to analyze the prescribing pattern and to identify the various drug-related problems (DRPs) associated with the therapy in chronic kidney disease (CKD) patients.

Subjects and methods: A prospective observational study was conducted in 160 patients diagnosed with any stages of CKD. The prescribing pattern was studied and DRPs were identified, reported, and categorized as per the Pharmaceutical Care Network Europe classification V 5.01. The association between categorical variables was analyzed using the Chi-square test. The predictors of DRPs were identified using binary logistic regression analysis.

Results: The mean age of the study population was 50.08 ± 15.32 years with male predominance (71%). The average number of drugs per prescription was found to be 9.16 ± 3.01. The most prescribed drug category was antihypertensives and the most commonly prescribed drugs were diuretics. A total of 337 DRPs were identified, out of which the most common DRP was drug interactions (60%), followed by frequency errors (11.6%). Logistic regression analysis identified comorbidities more than three (odds ratio 2.09), antihypertensives more than two (odds ratio 1.9), alcoholism (odds ratio 1.5), and polypharmacy (odds ratio 1.2) as the predictors of DRPs even though they were not statistically significant at P = 0.01.

Conclusion: DRPs increase the risk of deterioration of the disease state and increase the length of hospital stay. Identification and resolving of the DRPs will lead to better patient care and proper treatment. Early identification and modification of the above-mentioned predictors could possibly prevent/reduce DRPs.

Keywords: Chronic kidney disease; comorbidities; drug-related problems; polypharmacy; prescribing pattern.