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Prognostic impact of polypharmacy by drug essentiality in patients on hemodialysis

Although polypharmacy is common among patients on hemodialysis (HD), its association with prognosis remains unclear. This study aimed to elucidate the association between the number of prescribed medicines and all-cause mortality in patients on HD, accounting for essential medicines (i.e., antihyper...

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Autores principales: Kitamura, Mineaki, Yamaguchi, Kosei, Ota, Yuki, Notomi, Satoko, Komine, Maya, Etoh, Rika, Harada, Takashi, Funakoshi, Satoshi, Mukae, Hiroshi, Nishino, Tomoya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8688458/
https://www.ncbi.nlm.nih.gov/pubmed/34930934
http://dx.doi.org/10.1038/s41598-021-03772-0
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author Kitamura, Mineaki
Yamaguchi, Kosei
Ota, Yuki
Notomi, Satoko
Komine, Maya
Etoh, Rika
Harada, Takashi
Funakoshi, Satoshi
Mukae, Hiroshi
Nishino, Tomoya
author_facet Kitamura, Mineaki
Yamaguchi, Kosei
Ota, Yuki
Notomi, Satoko
Komine, Maya
Etoh, Rika
Harada, Takashi
Funakoshi, Satoshi
Mukae, Hiroshi
Nishino, Tomoya
author_sort Kitamura, Mineaki
collection PubMed
description Although polypharmacy is common among patients on hemodialysis (HD), its association with prognosis remains unclear. This study aimed to elucidate the association between the number of prescribed medicines and all-cause mortality in patients on HD, accounting for essential medicines (i.e., antihypertensives, antidiabetic medicines, and statins) and non-essential medicines. We evaluated 339 patients who underwent maintenance HD at Nagasaki Renal Center between July 2011 and June 2012 and followed up until June 2021. After adjusting for patient characteristics, the number of regularly prescribed medicines (10.0 ± 4.0) was not correlated with prognosis (hazard ratio [HR]: 1.01, 95% confidence interval [CI] 0.97–1.05, p = 0.60). However, the number of non-essential medicines (7.9 ± 3.6) was correlated with prognosis (HR: 1.06, 95% CI 1.01–1.10, p = 0.009). Adjusting for patient characteristics, patients who were prescribed more than 10 non-essential medicines were found to have a significantly higher probability of mortality than those prescribed less than five non-essential medicines, with a relative risk of 2.01 (p = 0.004). In conclusion, polypharmacy of non-essential medicines increases the risk of all-cause mortality in patients on HD. As such, prescribing essential medicines should be prioritized, and the clinical relevance of each medicine should be reviewed by physicians and pharmacists.
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spelling pubmed-86884582021-12-22 Prognostic impact of polypharmacy by drug essentiality in patients on hemodialysis Kitamura, Mineaki Yamaguchi, Kosei Ota, Yuki Notomi, Satoko Komine, Maya Etoh, Rika Harada, Takashi Funakoshi, Satoshi Mukae, Hiroshi Nishino, Tomoya Sci Rep Article Although polypharmacy is common among patients on hemodialysis (HD), its association with prognosis remains unclear. This study aimed to elucidate the association between the number of prescribed medicines and all-cause mortality in patients on HD, accounting for essential medicines (i.e., antihypertensives, antidiabetic medicines, and statins) and non-essential medicines. We evaluated 339 patients who underwent maintenance HD at Nagasaki Renal Center between July 2011 and June 2012 and followed up until June 2021. After adjusting for patient characteristics, the number of regularly prescribed medicines (10.0 ± 4.0) was not correlated with prognosis (hazard ratio [HR]: 1.01, 95% confidence interval [CI] 0.97–1.05, p = 0.60). However, the number of non-essential medicines (7.9 ± 3.6) was correlated with prognosis (HR: 1.06, 95% CI 1.01–1.10, p = 0.009). Adjusting for patient characteristics, patients who were prescribed more than 10 non-essential medicines were found to have a significantly higher probability of mortality than those prescribed less than five non-essential medicines, with a relative risk of 2.01 (p = 0.004). In conclusion, polypharmacy of non-essential medicines increases the risk of all-cause mortality in patients on HD. As such, prescribing essential medicines should be prioritized, and the clinical relevance of each medicine should be reviewed by physicians and pharmacists. Nature Publishing Group UK 2021-12-20 /pmc/articles/PMC8688458/ /pubmed/34930934 http://dx.doi.org/10.1038/s41598-021-03772-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Kitamura, Mineaki
Yamaguchi, Kosei
Ota, Yuki
Notomi, Satoko
Komine, Maya
Etoh, Rika
Harada, Takashi
Funakoshi, Satoshi
Mukae, Hiroshi
Nishino, Tomoya
Prognostic impact of polypharmacy by drug essentiality in patients on hemodialysis
title Prognostic impact of polypharmacy by drug essentiality in patients on hemodialysis
title_full Prognostic impact of polypharmacy by drug essentiality in patients on hemodialysis
title_fullStr Prognostic impact of polypharmacy by drug essentiality in patients on hemodialysis
title_full_unstemmed Prognostic impact of polypharmacy by drug essentiality in patients on hemodialysis
title_short Prognostic impact of polypharmacy by drug essentiality in patients on hemodialysis
title_sort prognostic impact of polypharmacy by drug essentiality in patients on hemodialysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8688458/
https://www.ncbi.nlm.nih.gov/pubmed/34930934
http://dx.doi.org/10.1038/s41598-021-03772-0
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