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Awareness and current implementation of drug dosage adjustment by pharmacists in patients with chronic kidney disease in Japan: a web-based survey

BACKGROUND: The aims of this study were to evaluate the current awareness of and implementation by pharmacists in Japan of adjustment of drug dosage according to renal function (ADDR) in patients with chronic kidney disease (CKD) and to clarify the factors influencing implementation of ADDR by commu...

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Autores principales: Kondo, Yuki, Ishitsuka, Yoichi, Shigemori, Eri, Irikura, Mitsuru, Kadowaki, Daisuke, Hirata, Sumio, Maemura, Takeshi, Irie, Tetsumi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258280/
https://www.ncbi.nlm.nih.gov/pubmed/25464858
http://dx.doi.org/10.1186/s12913-014-0615-0
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author Kondo, Yuki
Ishitsuka, Yoichi
Shigemori, Eri
Irikura, Mitsuru
Kadowaki, Daisuke
Hirata, Sumio
Maemura, Takeshi
Irie, Tetsumi
author_facet Kondo, Yuki
Ishitsuka, Yoichi
Shigemori, Eri
Irikura, Mitsuru
Kadowaki, Daisuke
Hirata, Sumio
Maemura, Takeshi
Irie, Tetsumi
author_sort Kondo, Yuki
collection PubMed
description BACKGROUND: The aims of this study were to evaluate the current awareness of and implementation by pharmacists in Japan of adjustment of drug dosage according to renal function (ADDR) in patients with chronic kidney disease (CKD) and to clarify the factors influencing implementation of ADDR by community pharmacists. METHODS: We conducted a web-based questionnaire of Japanese community and hospital pharmacists. Responders were compared by characteristics, rate of implementation of ADDR, experience with adverse drug events, pharmacist awareness of implementation of ADDR, and obstacles to ADDR implementation experienced by pharmacists. Additionally, the factors influencing the implementation of ADDR by community pharmacists were investigated by logistic regression analysis. RESULTS: Fewer community pharmacists had implemented ADDR than hospital pharmacists. The community pharmacists had less experience with adverse drug events caused by an inappropriate dosage than the hospital pharmacists, while the hospital pharmacists had encountered more severe adverse drug events than the community pharmacists. The community pharmacists had less awareness of ADDR implementation, and believed that problems in implementing ADDR were caused by a lack of information on the renal function of patients. In the logistic regression analysis, the factors influencing implementation of ADDR were “Routinely receiving prescriptions from nephrologists”, “Experience with adverse drug events caused by inappropriate dosage for CKD patients”, and “Awareness of the need for pharmacists to check the dosage of renally excreted drugs”; they did not include “Lack of information on patient renal function”. CONCLUSIONS: This study indicates that fewer Japanese community pharmacists than hospital pharmacists implement ADDR and that implementation of ADDR by community pharmacists is hindered by their limited awareness of the importance of patient renal function. We advocate that many countermeasures be introduced to prevent CKD patients from experiencing adverse drug events caused by inappropriate dosage. Such countermeasures would include a training program to educate pharmacists about the impact of impaired renal function on dosage of drugs that are excreted by the kidneys. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-014-0615-0) contains supplementary material, which is available to authorized users.
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spelling pubmed-42582802014-12-08 Awareness and current implementation of drug dosage adjustment by pharmacists in patients with chronic kidney disease in Japan: a web-based survey Kondo, Yuki Ishitsuka, Yoichi Shigemori, Eri Irikura, Mitsuru Kadowaki, Daisuke Hirata, Sumio Maemura, Takeshi Irie, Tetsumi BMC Health Serv Res Research Article BACKGROUND: The aims of this study were to evaluate the current awareness of and implementation by pharmacists in Japan of adjustment of drug dosage according to renal function (ADDR) in patients with chronic kidney disease (CKD) and to clarify the factors influencing implementation of ADDR by community pharmacists. METHODS: We conducted a web-based questionnaire of Japanese community and hospital pharmacists. Responders were compared by characteristics, rate of implementation of ADDR, experience with adverse drug events, pharmacist awareness of implementation of ADDR, and obstacles to ADDR implementation experienced by pharmacists. Additionally, the factors influencing the implementation of ADDR by community pharmacists were investigated by logistic regression analysis. RESULTS: Fewer community pharmacists had implemented ADDR than hospital pharmacists. The community pharmacists had less experience with adverse drug events caused by an inappropriate dosage than the hospital pharmacists, while the hospital pharmacists had encountered more severe adverse drug events than the community pharmacists. The community pharmacists had less awareness of ADDR implementation, and believed that problems in implementing ADDR were caused by a lack of information on the renal function of patients. In the logistic regression analysis, the factors influencing implementation of ADDR were “Routinely receiving prescriptions from nephrologists”, “Experience with adverse drug events caused by inappropriate dosage for CKD patients”, and “Awareness of the need for pharmacists to check the dosage of renally excreted drugs”; they did not include “Lack of information on patient renal function”. CONCLUSIONS: This study indicates that fewer Japanese community pharmacists than hospital pharmacists implement ADDR and that implementation of ADDR by community pharmacists is hindered by their limited awareness of the importance of patient renal function. We advocate that many countermeasures be introduced to prevent CKD patients from experiencing adverse drug events caused by inappropriate dosage. Such countermeasures would include a training program to educate pharmacists about the impact of impaired renal function on dosage of drugs that are excreted by the kidneys. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-014-0615-0) contains supplementary material, which is available to authorized users. BioMed Central 2014-12-03 /pmc/articles/PMC4258280/ /pubmed/25464858 http://dx.doi.org/10.1186/s12913-014-0615-0 Text en © Kondo et al.; licensee BioMed Central Ltd. 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Kondo, Yuki
Ishitsuka, Yoichi
Shigemori, Eri
Irikura, Mitsuru
Kadowaki, Daisuke
Hirata, Sumio
Maemura, Takeshi
Irie, Tetsumi
Awareness and current implementation of drug dosage adjustment by pharmacists in patients with chronic kidney disease in Japan: a web-based survey
title Awareness and current implementation of drug dosage adjustment by pharmacists in patients with chronic kidney disease in Japan: a web-based survey
title_full Awareness and current implementation of drug dosage adjustment by pharmacists in patients with chronic kidney disease in Japan: a web-based survey
title_fullStr Awareness and current implementation of drug dosage adjustment by pharmacists in patients with chronic kidney disease in Japan: a web-based survey
title_full_unstemmed Awareness and current implementation of drug dosage adjustment by pharmacists in patients with chronic kidney disease in Japan: a web-based survey
title_short Awareness and current implementation of drug dosage adjustment by pharmacists in patients with chronic kidney disease in Japan: a web-based survey
title_sort awareness and current implementation of drug dosage adjustment by pharmacists in patients with chronic kidney disease in japan: a web-based survey
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258280/
https://www.ncbi.nlm.nih.gov/pubmed/25464858
http://dx.doi.org/10.1186/s12913-014-0615-0
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