Assessment of used medications and drug-drug interactions among chronic renal failure patients

Authors

  • Vanessa Sgnaolin Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS).
  • Valéria Sgnaolin Hospital Nossa Senhora da Conceição (GHC).
  • Paula Engroff Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS).
  • Geraldo Attilio De Carli Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS).
  • Ana Elizabeth Prado Lima Figueiredo Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS).

DOI:

https://doi.org/10.15448/1980-6108.2014.4.17637

Keywords:

DRUG INTERACTIONS, RENAL INSUFFICIENCY, CHRONIC, HEMODIALYSIS UNITS, HOSPITAL

Abstract

AIMS: To describe the drugs most frequently used by patients in hemodialysis and to identify potential drug-drug interactions. METHODS: Cross-sectional study conducted in a hospital hemodialysis unit. Each combination of drugs prescription was analyzed in Micromedex©2014 Truven Health Analytics (Michigan, United States), to identify potential drug-drug interactions and classify them according to severity. RESULTS: Sixty-five patients were included. The mean age was 59.1±14.7 years and 50.8% were women. The occurrence of polypharmacy was 87.7%, with average of 6.3±3.1 medications/patient, the most frequent being calcium carbonate (n=55, 84.6%) and erythropoietin (n=47, 72.3%). The prevalence of potential drug-drug interactions was 56.9%, with median of one interaction per patient, and most were classified as moderate (49.1%) being the most frequent atenolol/calcium carbonate (n=9, 8.0%) and iron/calcium carbonate (n=9, 8.0%). The presence and number of potential moderate or important drug-drug interactions were significantly associated with the number of drugs used by the patient (P<0.001). CONCLUSIONS: The prevalence of potential drug-drug interactions was high and closely linked to the number of drugs used by each patient. The population with chronic kidney disease requires the use of various drugs, therefore the careful selection of therapeutic alternatives through pharmaceutical assistance is important for effective, rational and safe use of medicines.

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References

International Society of Nephrology. Kidney Disease Improving Global Outcomes. KDIGO 2012 Clinical Practice Guidelines for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl. 2013;3(1):1-150.

Stemer G, Lemmens-Gruber R. Clinical pharmacy activities in chronic kidney disease and end-stage renal disease patients: a systematic literature review. BMC Nephrol. 2011;12:35.

Joshua L, Devi PD, Guido S. Adverse drug reactions in nephrology ward inpatients of a tertiary care hospital. Indian J Med Sci. 2007;61(10):562-9.

Goldberg RM, Mabee J, Chan L, Wong S. Drug-drug and drug-disease interactions in the ED: analysis of a high-risk population. Am J Emerg Med. 1996;14(5):447-50.

Magro L, Conforti A, Del Zotti F, Leone R, Iorio ML, Meneghelli I, Massignani D, Visonà E, Moretti U. Identification of severe potential drug-drug interactions using an Italian general-practitioner database. Eur J Clin Pharmacol. 2008;64(3):303-9.

Bucşa C, Farcaş A, Cazacu I, Leucuta D, Achimas-Cadariu A, Mogosan C, Bojita M. How many potential drug-drug interactions cause adverse drug reactions in hospitalized patients? Eur J Intern Med. 2013;24(1):27-33.

Malone DC1, Abarca J, Hansten PD, Grizzle AJ, Armstrong EP, Van Bergen RC, Duncan-Edgar BS, Solomon SL, Lipton RB. Identification of serious drug-drug interactions: results of the partnership to prevent drug-drug interactions. J Am Pharm Assoc. 2004;44(2):142-51.

Sepehri G, Khazaelli P, Dahooie FA, Sepehri E, Dehghani MR. Prevalence of potential drug interactions in an Iranian general hospital. Indian J Pharm Sci. 2012;74(1):75-9.

Teixeira JJ, Crozatti MT, dos Santos CA, Romano-Lieber NS. Potential drug-drug interactions in prescriptions to patients over 45 years of age in primary care, southern Brazil. PLoS One. 2012;7(10):e47062.

Gagne JJ, Maio V, Rabinowitz C. Prevalence and predictors of potential drug-drug interactions in Regione Emilia-Romagna, Italy. J Clin Pharm Ther. 2008;33(2):141-51.

Cruciol-Souza JM, Thomson JC. A pharmacoepidemiologic study of drug interactions in a brazilian teaching hospital. Clinics. 2006;61(6):515-20.

Glintborg B, Andersen SE, Dalhoff K. Drug-drug interactions among recently hospitalized patients - frequent but mostly clinically insignificant. Eur J Clin Pharmacol. 2005;61(9):675-81.

Cruciol-Souza JM, Thomson JC. Prevalence of potential drug-drug interactions and its associated factors in a Brazilian teaching hospital. J Pharm Pharm Sci. 2006;9(3):427-33.

Vonbach P, Dubied A, Krähenbühl S, Beer JH. Prevalence of drug-drug interactions at hospital entry and during hospital stay of patients in internal medicine. Eur J Intern Med. 2008;19(6):413-20.

Grönroos PE, Irjala KM, Huupponen RK, Scheinin H, Forsström J, Forsström JJ. A medication database - a tool for detecting drug interactions in hospital. Eur J Clin Pharmacol. 1997;53(1):13-7.

Bjerrum L, Andersen M, Petersen G, Kragstrup J. Exposure to potential drug interactions in primary health care. Scand J Prim Health Care. 2003;21(3):153-8.

Björkman IK, Fastbom J, Schmidt IK, Bernsten CB. Pharmaceutical Care of the Elderly in Europe Research (PEER) Group. Drug-drug interactions in the elderly. Ann Pharmacother. 2002;36(11):1675-81.

Bergendal L, Friberg A, Schaffrath A. Potential drug-drug interactions in 5125 mostly elderly out-patients in Gothenburg, Sweden. Pharm World Sci. 1995;17(5):152-7.

Costa AJ. Potential drug interactions in an ambulatory geriatric population. Fam Pract. 1991;8(3):234-6.

Rosholm JU, Bjerrum L, Hallas J, Worm J, Gram LF. Polypharmacy and the risk of drug-drug interactions among Danish elderly. A prescription database study. Dan Med Bull. 1998;45(2):210-3.

Riemer E, Werling E, Kribs M, Hamman De Compte A, Dimitrov Y. Medical prescriptions in haemodialysis patients: critical analysis. Nephrol Ther. 2005;1(4):234-40.

Rama M, Viswanathan G, Acharya LD, Attur RP, Reddy PN, Raghavan SV. Assessment of Drug-Drug Interactions among Renal Failure Patients of Nephrology Ward in a South Indian Tertiary Care Hospital. Indian J Pharm Sci. 2012;74(1):63-8.

Marquito AB, Fernandes NM, Colugnati FA, de Paula RB. Identifying potential drug interactions in chronic kidney disease patients. J Bras Nefrol. 2014;36(1):26-34.

Vonbach P, Dubied A, Beer JH, Krähenbühl S. Recognition and management of potential drug-drug interactions in patients on internal medicine wards. Eur J Clin Pharmacol. 2007;63(11):1075-83.

WHO Collaborating Centre for Drug Statistics Methodology. Guidelines for ATC classification and DDD assignment 2014. Oslo: Norwegian Institute of Public Health; 2013.

Moreira LB, Fernandes PFBC, Monte FS, Martins AMC. Adesão ao Tratamento Farmacológico em Pacientes com Doença Renal Crônica. J Bras Nefrol. 2008;30(2):113-9.

Moreira LB, Fernandes PFBC, Monte FS, Galvão RIM, Martins AMC. Conhecimento sobre o tratamento farmacológico em pacientes com doença renal crônica. Rev Bras Cienc Farm. 2008;44(2):315-25.

Manley HJ, McClaran ML, Overbay DK, Wright MA, Reid GM, Bender WL, Neufeld TK, Hebbar S, Muther RS. Factors associated with medication-related problems in ambulatory hemodialysis patients. Am J Kidney Dis. 2003;41:386-93.

Manley HJ, Drayer DK, Muther RS. Medication related problem type and appearance rate in ambulatory hemodialysis patients. BMC Nephrol. 2003;4:10.

Grabe DW, Bailie GR, Manley HJ, Yeaw BF. The early patient-orientated care program as an educational tool and service.Am J Pharm Educ. 1998;62:279-84.

Grabe DW, Low CL, Bailie GR, Eisele G. Evaluation of drug-related problems in an outpatient hemodialysis unit and the impact of a clinical pharmacist. Clin Nephrol. 1997;121:459-64.

Sánchez-Gili M, Toro-Chico P, Pérez-Encinas M, Gómez-Pedrero AM, Portolés-Pérez JM. Pharmaceutical intervention on the therapeutic adherence in patients with chronic renal disease. Rev Calid Asist. 2011;26(3):146-51.

Rifkin DE, Laws MB, Rao M, Balakrishnan VS, Sarnak MJ, Wilson IB. Medication adherence behavior and priorities among older adults with CKD: a semistructured interview study. Am J Kidney Dis. 2010;56(3):439-46.

Fokter N, Mozina M, Brvar M. Potential drug-drug interactions and admissions due to drug-drug interactions in patients treated in medical departments. Wien Klin Wochenschr. 2010;122(3-4):81-8.

Loya AM, González-Stuart A, Rivera JO. Prevalence of polypharmacy, polyherbacy, nutritional supplement use and potential product interactions among older adults living on the United States-Mexico border: a descriptive, questionnaire-based study. Drugs Aging. 2009;26(5):423-36.

Correr CJ, Pontarolo R, Ferreira LC, Baptistão SAM. Riscos de problemas relacionados com medicamentos em pacientes de uma instituição geriátrica. Rev Bras Cienc Farm. 2007;43(1):55-62.

Janchawee B, Wongpoowarak W, Owatranporn T, Chongsuvivatwong V. Pharmacoepidemiologic study of potential drug interactions in outpatients of a university hospital in Thailand. J Clin Pharm Ther. 2005;30(1):13-20.

Yunes LP, Coelho TA, Almeida SM. Principais interações medicamentosas em pacientes da UTI-adulto de um hospital privado de minas gerais. R Bras Farm Hosp Serv Saúde São Paulo. 2011;2(3):23-6.

Nabovati E, Vakili-Arki H, Taherzadeh Z, Hasibian MR, Abu-Hanna A, Eslami S. Daru. Drug-drug interactions in inpatient and outpatient settings in Iran: a systematic review of the literature. Daru. 2014;22:52.

Tannenbaum C, Sheehan NL. Understanding and preventing drug-drug and drug-gene interactions. Expert Rev Clin Pharmacol. 2014;7(4):533-44.

Belaiche S, Romanet T, Bell R, Calop J, Allenet B, Zaoui P. Pharmaceutical care in chronic kidney disease: experience at Grenoble University Hospital from 2006 to 2010. J Nephrol. 2012;25(4):558-65.

Mason NA. Polypharmacy and medication-related complications in the chronic kidney disease patient. Curr Opin Nephrol Hypertens. 2011;20(5):492-7.

Mason NA, Bakus JL. Strategies for reducing polypharmacy and other medication-related problems in chronic kidney disease. Semin Dial. 2010;23(1):55-61.

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Published

2014-12-11

How to Cite

Sgnaolin, V., Sgnaolin, V., Engroff, P., De Carli, G. A., & Prado Lima Figueiredo, A. E. (2014). Assessment of used medications and drug-drug interactions among chronic renal failure patients. Scientia Medica, 24(4), 329–335. https://doi.org/10.15448/1980-6108.2014.4.17637

Issue

Vol. 24 No. 4 (2014)

Section

Original Articles

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