Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Factors Contributing to Negative Outcomes Associated with Medications and Drug-Related Problems in Kidney Replacement Therapy. A Hospital-Based Prospective Observational Study

Version 1 : Received: 15 January 2024 / Approved: 16 January 2024 / Online: 16 January 2024 (13:57:35 CET)

A peer-reviewed article of this Preprint also exists.

Pereira-Céspedes, A.; Jiménez-Morales, A.; Polo-Moyano, A.; Palomares-Bayo, M.; Martínez-Martínez, F.; Calleja-Hernández, M.Á. Factors Contributing to Negative Outcomes Associated with Medications and Drug-Related Problems in Kidney Replacement Therapy—A Hospital-Based Prospective Observational Study. J. Clin. Med. 2024, 13, 1048. Pereira-Céspedes, A.; Jiménez-Morales, A.; Polo-Moyano, A.; Palomares-Bayo, M.; Martínez-Martínez, F.; Calleja-Hernández, M.Á. Factors Contributing to Negative Outcomes Associated with Medications and Drug-Related Problems in Kidney Replacement Therapy—A Hospital-Based Prospective Observational Study. J. Clin. Med. 2024, 13, 1048.

Abstract

.Background: Negative outcomes associated with medications (NOM) and drug-related problems (DRP) significantly impact individuals with kidney replacement therapy (KRT) given the complexities of managing kidney disease and associated comorbidities. The present study aims to assess the frequency of NOMs/DRPs among KRT patients and identify contributing factors. Methods: A cross-sectional study was conducted at the Virgen de las Nieves University Hospital (Granada, Spain), involving 117 outpatient adults with KRT. Data were collected from February 2021 to July 2023 using electronic records, semi-structured interviews (Dáder Method), and discussions with nephrology specialists. NOMs/DRPs were identified following treatment guidelines. Binary logistic regression determined associated factors (p-value < 0.05). Results: Across 117 patients, 2,436 NOMs and 3,303 DRPs were identified, averaging 20.82 NOMs and 28.23 DRPs per patient. Prevalent NOMs included untreated conditions (58.95%), quantitative ineffectiveness (35.43%), and non-quantitative safety problems (5.13%). Dominant DRPs were undertreated conditions (37.63%), wrong dose/posology/length (33.00%), risk of adverse drug reactions (ADR) (16.14%), and non-adherence (6.87%). Patients with ADR, undertreated condi-tions, and anemia were associated with quantitative ineffectiveness. Risk of ADR and vitamin D deficiency/insufficiency correlated with non-quantitative safety problems. Conclusions: KRT pa-tients exhibited a substantial prevalence of NOMs/DRPs. Further research is needed to deepen our understanding of these complexities for improved patient care.

Keywords

kidney replacement therapy; medication review; drug-related problems; negative outcomes associated with medication.

Subject

Medicine and Pharmacology, Urology and Nephrology

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