Prescription Audit of CKD Patients in Nephrology Department of a Tertiary Care Hospital: An Observational Prospective Study
DOI:
https://doi.org/10.63682/jns.v14i16S.4430Keywords:
Chronic kidney disease, prescription audit, drug utilization, medication errors, pharmacotherapy, nephrology, drug interactions, patient safetyAbstract
Background: A major global health concern that is linked to a considerable morbidity, mortality, and financial burden is chronic kidney disease. In addition to discussing risk factors, management techniques, stages, causes, and pharmaceutical concerns, this study offers a succinct summary of chronic kidney disease. In addition to highlighting the gradual progression of CKD and its wide range of contributing factors, such as diabetes, hypertension, genetic susceptibility, and drug toxicity, the review emphasizes the significance of early identification and intervention. Modest lifestyle changes, medication-assisted therapies, and routine patient monitoring are all components of successful management regimens. A thorough grasp of CKD enables cooperative efforts to lessen its effects on public health and supports well-informed decision-making.
MATERIALS AND METHODS: This study was designed as a prospective observational study. Our inclusion criteria include Patients of both sexes, Patients willing to participate in the study and provide written and dated informed consent, patients diagnosed with chronic kidney disease (CKD),patients aged above 25 years. Exclusion Criteria: Patients unwilling to participate or unwilling to provide informed consent, patients aged below 25 years.
All collected data were systematically compiled, tabulated, and subjected to statistical analysis. Various graphical representations, including tables, figures, and charts, were employed to summarize and present the results effectively.
The Chi-square test was applied for statistical analysis to determine the significance of associationns within the data.
Result: A study of 150 CKD patients found the highest prevalence in ages 51-60. Common comorbidities were diabetes (31%) and hypertension (27%). Antibiotics were prescribed to all. Drug interactions occurred in 28.7% of cases, and prescription errors included dose (16%) and frequency (6.7%). Only 4.7% lacked a doctor's signature.
Downloads
Metrics
References
Shalini S, Ravichandran V, Mohanty BK, Dhanaraj SK, Saraswathi R. Drug utilization studiesAn overview. International Journal of Pharmaceutical Sciences and Nanotechnology. 2010;3:803- 10.
Sonika Niraj Motan, Anusha Vohra, & Mohammed Shoaib. (2023). PRESCRIPTION PATTERN OF MEDICINES IN CHRONIC KIDNEY DISEASE PATIENTS IN NEPHROLOGY DEPARTMENT OF A TERTIARY CARE TEACHING HOSPITAL: AN OBSERVATIONAL STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 30(16), 753-760. https://doi.org/10.53555/jptcp.v30i16.1933
Chakraborty S, Ghosh S, Banerjea A, De RR, Hazra A, Mandal SK. Prescribing patterns of medicines in chronic kidney disease patients on maintenance hemodialysis. Indian J Pharmacol. 2016 Sep-Oct;48(5):586-590. doi: 10.4103/0253-7613.190760. PMID: 27721548; PMCID: PMC5051256.
Nelms CL, Shaw V, Greenbaum LA, Anderson C, Desloovere A, Haffner D, Oosterveld MJ, Paglialonga F, Polderman N, Qizalbash L, Rees L. Assessment of nutritional status in children with kidney diseases—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce. Pediatric Nephrology. 2021 Apr;36:995-1010.
Haffner D. Strategies for optimizing growth in children with chronic kidney disease. Frontiers in pediatrics. 2020 Jul 30;8:399.
Hundemer GL, Tangri N, Sood MM, Ramsay T, Bugeja A, Brown PA, Clark EG, Biyani M, White CA, Akbari A. Performance of the kidney failure risk equation by disease etiology in advanced CKD. Clinical Journal of the American Society of Nephrology. 2020 Oct 1;15(10):1424-32.
Kidney T (1952) Structure and function in health and disease. Postgrad Med J 28(317):191–192 Shannon JA, Smith HW (1935) The excretion of inulin, xylose and urea by normal and phlorizinized man. J Clin Invest 14(4):393–401
Heinze M, Schell M, Nägele FL, Cheng B, Flottmann F, Fiehler J, Schmidt-Lauber C, Thomalla G. Kidney dysfunction predicts 90 days mortality after stroke thrombectomy independent of cardiovascular risk factors and chronic kidney disease. European Stroke Journal. 2024 Jan 9:23969873231224200.
Davison SN, Tupala B, Wasylynuk BA, Siu V, Sinnarajah A, Triscott J. Recommendations for the care of patients receiving conservative kidney management: focus on management of CKD and symptoms. Clinical Journal of the American Society of Nephrology. 2019 Apr 1;14(4):626-34.
Muntner P, Anderson A, Charleston J, Chen Z, Ford V, Makos G, O’Connor A, Perumal K, Rahman M, Steigerwalt S, Teal V, Townsend R, Weir M, Wright JT Jr; Chronic Renal Insufficiency Cohort (CRIC) Study Investigators: Hypertension awareness, treatment, and control in adults with CKD: Results from the Chronic Renal Insufficiency Cohort (CRIC) study. Am J Kidney Dis 55: 441–451, 2010
Debella YT, Giduma HD, Light RP, Agarwal R: Chronic kidney disease as a coronary disease equivalent--a comparison with diabetes over a decade. Clin J Am Soc Nephrol 6: 1385–1392, 2011
Tauro CM, Kamath JV, Mishal M, Hateefa Z. Assessment of Prescribing Patterns of Drugs in Chronic Kidney Disease Patients in a Tertiary Care Hospital. Indian Journal of Pharmacy Practice.
Sonoda A, Kondo Y, Iwashita Y, Nakao S, Ishida K, Irie T, Ishitsuka Y. In-hospital prescription checking system for hospitalized patients with decreased glomerular filtration rate.
Nafih A, Mateti UV, Shenoy P, Shivaprasad S, Moorthy J. A study on prescribing patterns in hemodialysis and renal transplantation patients. Egyptian Pharmaceutical Journal.
Meenakshi R, Selvaraj N, Anandabaskar N, Dhamodharan A, Badrinath AK, Rajamohammad MA. Prescription audit of a teaching hospital in South India using World Health Organization core prescribing indicators–A cross-sectional study. Perspectives in Clinical Research.
Jamaluddin J, Yassin MS, Jamil SN, Kamel MA, Yusof MY. A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic. Malaysian family physician: the official journal of the Academy of Family Physicians of Malaysia.
Beg MA, Dutta S, Varma A, Kant R, Bawa S, Anjoom M. Study on drug prescribing pattern in hypertensive patients in a tertiary care teaching hospital at Dehradun, Uttarakhand. Int J Med Sci Public Health.
Sinha AD, Agarwal R. Clinical pharmacology of antihypertensive therapy for the treatment of hypertension in CKD. Clinical Journal of the American Society of Nephrology. 2019 May 1;14(5):757-64.
Rebecca Noble, Maarten W. Taal, Epidemiology and causes of chronic kidney disease, Medicine,Volume 47, Issue 9,2019,Pages 562-566,ISSN 1357-3039,https://doi.org/10.1016/j.mpmed.2019.06.010.
Awdishu L, Coates CR, Lyddane A, Tran K, Daniels CE, Lee J, El-Kareh R. The impact of real-time alerting on appropriate prescribing in kidney disease: a cluster randomized controlled trial. Journal of the American Medical Informatics Association.
Phillips M, Wilson JA, Aly A, Wood M, Poyah P, Drost S, Hiltz A, Carver H. An evaluation of medication reconciliation in an outpatient nephrology clinic.
Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(13):1296–305.
Navadia KP, Patel CR, Patel JM, Pandya SK. Evaluation of Medication Errors by Prescription Audit at a Tertiary Care Teaching Hospital. Journal of Pharmacology and Pharmacotherapeutics.
Mallamaci F, Tripepi G. Risk Factors of Chronic Kidney Disease Progression: Between Old and New Concepts. Journal of Clinical Medicine. 2024 Jan 24;13(3):678
Schena FP. Management of patients with chronic kidney disease. Internal and emergency medicine. 2011 Oct;6:77-83.
Walther CP, Nambi V, Hanania NA, Navaneethan SD. Diagnosis and management of pulmonary hypertension in patients with CKD. American Journal of Kidney Diseases. 2020 Jun 1;75(6):935-45. the American College of Gastroenterology| ACG. 2018 Nov 1;113(11):1581.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
