Cargando…

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

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 s...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, A Jeong, Lee, Hayeon, Shin, Eun-Jeong, Cho, Eun-Jung, Cho, Yoon Sook, Lee, Hajeong, Lee, Ju-Yeun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8074256/
https://www.ncbi.nlm.nih.gov/pubmed/33924094
http://dx.doi.org/10.3390/ijerph18084370
_version_ 1783684314015203328
author Kim, A Jeong
Lee, Hayeon
Shin, Eun-Jeong
Cho, Eun-Jung
Cho, Yoon Sook
Lee, Hajeong
Lee, Ju-Yeun
author_facet Kim, A Jeong
Lee, Hayeon
Shin, Eun-Jeong
Cho, Eun-Jung
Cho, Yoon Sook
Lee, Hajeong
Lee, Ju-Yeun
author_sort Kim, A Jeong
collection PubMed
description 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.
format Online
Article
Text
id pubmed-8074256
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-80742562021-04-27 Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy Kim, A Jeong Lee, Hayeon Shin, Eun-Jeong Cho, Eun-Jung Cho, Yoon Sook Lee, Hajeong Lee, Ju-Yeun Int J Environ Res Public Health Article 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. MDPI 2021-04-20 /pmc/articles/PMC8074256/ /pubmed/33924094 http://dx.doi.org/10.3390/ijerph18084370 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, A Jeong
Lee, Hayeon
Shin, Eun-Jeong
Cho, Eun-Jung
Cho, Yoon Sook
Lee, Hajeong
Lee, Ju-Yeun
Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy
title Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy
title_full Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy
title_fullStr Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy
title_full_unstemmed Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy
title_short Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy
title_sort pharmacist-led collaborative medication management for the elderly with chronic kidney disease and polypharmacy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8074256/
https://www.ncbi.nlm.nih.gov/pubmed/33924094
http://dx.doi.org/10.3390/ijerph18084370
work_keys_str_mv AT kimajeong pharmacistledcollaborativemedicationmanagementfortheelderlywithchronickidneydiseaseandpolypharmacy
AT leehayeon pharmacistledcollaborativemedicationmanagementfortheelderlywithchronickidneydiseaseandpolypharmacy
AT shineunjeong pharmacistledcollaborativemedicationmanagementfortheelderlywithchronickidneydiseaseandpolypharmacy
AT choeunjung pharmacistledcollaborativemedicationmanagementfortheelderlywithchronickidneydiseaseandpolypharmacy
AT choyoonsook pharmacistledcollaborativemedicationmanagementfortheelderlywithchronickidneydiseaseandpolypharmacy
AT leehajeong pharmacistledcollaborativemedicationmanagementfortheelderlywithchronickidneydiseaseandpolypharmacy
AT leejuyeun pharmacistledcollaborativemedicationmanagementfortheelderlywithchronickidneydiseaseandpolypharmacy