Factors associated with potentially inappropriate prescribing in elderly patients with various degrees of chronic kidney disease

IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY Hemodialysis International Pub Date : 2024-07-03 DOI:10.1111/hdi.13171
Gorana G. Nedin Rankovic, Ana V. Pejcic, Dane A. Krtinic, Dragana S. Stokanovic, Hristina S. Trajkovic, Hristina M. Jovanovic, Iva I. Binic, Slobodan M. Jankovic
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Abstract

Introduction

This study aimed to compare the prevalence of potentially inappropriately prescribed drugs in hemodialysis patients and patients with chronic kidney disease who did not require renal replacement therapy, as well as to identify risk factors associated with potentially inappropriate prescribing.

Methods

The study was designed as a cross-sectional study conducted at the Department of Nephrology, Clinical Center in Nis, Serbia. The patients were divided into two groups: (1) patients on hemodialysis treatment and (2) patients with various degrees of chronic kidney disease without renal replacement therapy. The presence or absence of potentially inappropriate prescribing was determined using the 2015 AGS Beers criteria.

Findings

The study included a total of 218 patients aged 65 years and over. The number of patients with potentially inappropriate prescribed drugs did not differ significantly (chi-square = 0.000, p = 1.000) between patients on hemodialysis (27 of 83, i.e., 32.5%) and patients with various degrees of chronic kidney disease without renal replacement therapy (44 of 135, i.e., 32.6%). Factors associated with potentially inappropriate prescribing in hemodialysis patients were the number of drugs (hazard ratio [HR] = 1.919, 95% confidence interval [CI]: 1.325–2.780) and number of comorbidities (HR = 1.743, 95% CI: 1.109–2.740). The number of drugs (HR = 1.438, 95% CI: 1.191–1.736) was the only independent factor associated with increased risk of potentially inappropriate prescribing in patients without renal replacement therapy.

Discussion

Our study showed that potentially inappropriate prescribing is a relatively frequent phenomenon present in about a third of patients in both study groups. The number of prescribed drugs was the main factor associated with the increased risk of potentially inappropriate prescribing in both groups.

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与患有不同程度慢性肾病的老年患者的潜在不当处方相关的因素。
导言:本研究旨在比较血液透析患者和不需要肾脏替代治疗的慢性肾脏病患者潜在处方药不当的发生率,并确定与潜在处方药不当相关的风险因素:这项研究是在塞尔维亚尼什临床中心肾脏内科进行的一项横断面研究。患者分为两组:(1) 接受血液透析治疗的患者;(2) 患有不同程度慢性肾病但未接受肾脏替代治疗的患者。根据 2015 AGS Beers 标准确定是否存在潜在的不当处方:研究共纳入了 218 名 65 岁及以上的患者。血液透析患者(83 例中有 27 例,即 32.5%)与患有不同程度慢性肾病但未接受肾脏替代治疗的患者(135 例中有 44 例,即 32.6%)之间存在潜在不适当处方药物的患者人数无显著差异(秩和=0.000,P=1.000)。与血液透析患者潜在处方不当相关的因素是药物数量(危险比 [HR] = 1.919,95% 置信区间 [CI]:1.325-2.780)和合并症数量(HR = 1.743,95% 置信区间 [CI]:1.109-2.740)。药物数量(HR = 1.438,95% CI:1.191-1.736)是唯一与未接受肾脏替代治疗的患者潜在不当处方风险增加相关的独立因素:我们的研究表明,在两个研究组中,约有三分之一的患者存在潜在处方不当的现象。处方药物的数量是导致两组患者潜在不当处方风险增加的主要因素。
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来源期刊
Hemodialysis International
Hemodialysis International UROLOGY & NEPHROLOGY-
CiteScore
2.50
自引率
0.00%
发文量
58
审稿时长
6-12 weeks
期刊介绍: Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis. The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.
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