Drug Prescribing in Patients with Impaired Renal Function: are Interventions Still Needed to Improve Patient Safety?

An intervention study of 3 months was performed at a third-level university hospital to investigate if drug adjustment interventions towards chronic kidney disease (CKD) patients are still needed. Patients with a glomerular filtration rate < 60 mL/min/1.73 m2 and a prescribed medication that needed an adjustment for CKD were selected. Demographic and clinical data, prescription information, non-adjusted medication, interventions, and acceptance of recommendation were registered. A total of 706 patients were included (77.5 % stage 3 of CKD, 13.2 % stage 4 and 7.2 % stage 5), 281 (8.5 %) of 3,315 prescriptions were considered non-adjusted (52.3 % stage 3, 28.8 % stage 4 and 18.9 % stage 5) and were intervened: 220 (78.3 %) dose reduction, 32 (11.4 %) contraindicated, 21 (7.5 %) follow up, and 8 (2.8 %) dose increment. Fifty per cent of the interventions were accepted. Antibiotics became in 45 % of the interventions. Intervention and education about the important of drug adjustment in CKD is still needed to improve safety on these patients. Colegio de Farmacéuticos de la Provincia de Buenos Aires