Prevalence and influence factor of drug-related problems in inpatients with kidney disease: a prospective single central study

Guoguang Gu; Yanping Li; Yunyun Hu; Hengyi Zhao; Xingdong Wang; Xiaomin Li; Xinran Zhang; Hong Zhu; Xiaohua Dai; Xingxing Liu; Liyan Miao; Jianguo Zhu; Yongfu Hang

doi:10.3389/fphar.2024.1436561

Prevalence and influence factor of drug-related problems in inpatients with kidney disease: a prospective single central study

Front Pharmacol. 2024 Oct 30:15:1436561. doi: 10.3389/fphar.2024.1436561. eCollection 2024.

Authors

Guoguang Gu^#¹, Yanping Li^#², Yunyun Hu^#³, Hengyi Zhao^#⁴, Xingdong Wang⁵, Xiaomin Li⁶, Xinran Zhang⁷, Hong Zhu⁸, Xiaohua Dai⁹, Xingxing Liu¹⁰, Liyan Miao¹, Jianguo Zhu¹, Yongfu Hang¹

Affiliations

¹ Department of Pharmacy, The First Affiliated Hospital of Soochow University, Suzhou, China.
² Department of Pharmacy, The First affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
³ Department of Pharmacy, Suzhou Xiangcheng People's Hospital, Suzhou, China.
⁴ Department of Pharmacy, Xuzhou Central Hospital, Xuzhou, China.
⁵ Department of Pharmacy, The First Hospital of Lanzhou University, Lanzhou, China.
⁶ Department of Pharmacy, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.
⁷ Department of Pharmacy, Tianjin First Central Hospital, Tianjin, China.
⁸ Department of Pharmacy, Suzhou Kowloon Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Suzhou, China.
⁹ Department of Pharmacy, Zhaoqing First People's Hospital, Zhaoqing, China.
¹⁰ Department of Pharmacy, Guiyang Maternal and Child Healthcare Hospital, Guiyang, China.

^# Contributed equally.

Abstract

Aims: To investigate the prevalence and influencing factors of drug-related problems (DRPs) in inpatients with kidney disease to provide reference data for pharmaceutical care.

Methods: The basic information, diagnoses, and medication reconciliation (MR) of inpatients in the Department of Nephrology at our hospital between October 2020 and September 2021 were collected. The Chinese-modified DRP version based on the PCNE classification (Version 9.1) was used to assess, intervene and statistically analyze the results of the patients' DRPs. The influence factor of DRPs in inpatients with kidney disease was analyzed by the multivariate binary logistic regression.

Results: Of 623 patients included in this study, 132 (21.80%) had DRPs. The prevalence of anemia was significantly higher in patients with DRPs than those without DRPs (43.18% vs. 28.72%, p < 0.05), the mean number of drug types consumed (7.25 ± 3.44 with DRPs vs. 5.93 ± 3.58 without DRPs, p < 0.05) and the proportion of ≥5 drugs (%) (79.55% with DRPs vs 58.04% without DRPs, p < 0.05) were significantly increased. In addition, the prevalence of hypertension (76.52% vs. 68.64%), diabetes (27.27% vs. 22.20%) and hyperuricemia (16.67% vs. 13.65%) in DRP patients were higher than those without DRPs, but there was no statistical difference (p > 0.05). The logistic regression analysis showed that patients with anemia (OR = 1.702, 95%CI: 1.146-2.529, p = 0.008), average number of medication types taken (OR = 1.089, 95%CI: 1.034-1.147, p = 0.001) significantly increased the risk of DRPs. The distribution of harm levels was as follows: 78 problems (59.09%) were level C, 29 (21.97%) were level B, 10 (7.58%) were level D, 7 (5.30%) were level A, 7 (5.30%) were level E, and 1 (0.76%) were level F. All DRPs were resolved after 128 interventions.

Conclusion: Renal anemia, the average number of drug varieties consumed, and the proportion of ≥5 drugs are associated with the occurrence of DRPs. Pharmacists conducting MR services can reduce DRPs of inpatients in the department of nephrology and ensure patient drug safety.

Keywords: clinical pharmacist; drug-related problems (DRPs); kidney disease; medication reconciliation; renal anemia.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This research was supported by Key Medical Disciplines of Jiangsu Province (ZDXK202247) and the Suzhou Science and Technology Development Plan Guiding Project (SKYXD2022017).