Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy

International Journal of Environmental Research and Public Health

Ju-Yeun Lee¹  Eun-Jung Cho²  Eun-Jeong Shin²  A Jeong Kim²  Hayeon Lee²  Yoon-Sook Cho²  Hajeong Lee³ 

[1] College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Korea;Department of Pharmacy, Seoul National University Hospital, Seoul 03080, Korea;Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Korea;

关键词: geriatric;    potentially inappropriate medications;    polypharmacy;    medication management service;    chronic kidney disease;   

DOI  :  10.3390/ijerph18084370

来源: DOAJ

【 摘 要 】

Inappropriate polypharmacy is likely in older adults with chronic kidney disease (CKD) owing to the considerable burden of comorbidities. We aimed to describe the impact of pharmacist-led geriatric medication management service (MMS) on the quality of medication use. This retrospective descriptive study included 95 patients who received geriatric MMS in an ambulatory care clinic in a single tertiary-care teaching hospital from May 2019 to December 2019. The average age of the patients was 74.9 ± 7.3 years; 40% of them had CKD Stage 4 or 5. Medication use quality was assessed in 87 patients. After providing MMS, the total number of medications and potentially inappropriate medications (PIMs) decreased from 13.5 ± 4.3 to 10.9 ± 3.8 and 1.6 ± 1.4 to 1.0 ± 1.2 (both p < 0.001), respectively. Furthermore, the number of patients who received three or more central nervous system-active drugs and strong anticholinergic drugs decreased. Among the 354 drug-related problems identified, “missing patient documentation” was the most common, followed by “adverse effect” and “drug not indicated.” The most frequent intervention was “therapy stopped”. In conclusion, polypharmacy and PIMs were prevalent in older adults with CKD; pharmacist-led geriatric MMS improved the quality of medication use in this population.

【 授权许可】

Unknown