Introduction:
Drug-related problems (DRPs) are considered one of the major challenges in healthcare, particularly within the nephrology department, where managing kidney patients often requires polypharmacy and precise balance in medication prescriptions. In this context, we aim to explore the prevalence of DRPs and the factors influencing them among hospitalized kidney patients to study their impact on patient safety and drug efficacy. This article will discuss data conducted on 623 patients in the nephrology department over a specific period, using a modified classification of drug problems. The article addresses the results of statistical analysis and provides insights on how to improve pharmaceutical care for these patients, reflecting the significant role of pharmacists in reducing therapy-related risks and ensuring safe and effective medication use.
Introduction to Drug Problems in Kidney Patients
The nephrology department is one of the complex medical fields that requires special attention when using medications. Kidney diseases often suffer from accompanying complications, such as hypertension and diabetes, which complicate the patient’s condition further. This requires the use of multiple medications, increasing the likelihood of drug interactions. The dosages of medications must be carefully adjusted according to the patient’s kidney function, with regular monitoring of patients to ensure treatments are provided effectively and safely. Drug problems, which refer to any issues related to the safe and effective use of medications, are very common in kidney patients at various stages of their illness. This makes evaluating these problems a necessary step to improve patient care.
Research Methods and Approaches Used
Information was collected from patients in the nephrology department through a comprehensive study that extended from October 2020 to September 2021. The focus was on assessing patient information, including medical history and prescribed medications. A modified version of the drug problem classification based on the PCNE classification was adopted as a tool for assessing and analyzing potential problems. The research team employed various methods, including assessments through questionnaires and data aggregation to determine the prevalence of drug problems and the associated risk factors. The use of a multiple binary statistical analysis model was essential for measuring the risk rate and problems related to patient-relevant medications.
Study Results and Prevalence of Drug Problems
The results showed that the rate of drug problems among kidney patients was high, with 132 out of 623 patients in the study experiencing drug-related issues, indicating a rate of 21.8%. The prevalence of anemia was particularly evident in these patients, with groups experiencing drug problems showing a higher rate of anemia compared to patients without such issues. Additionally, the use of multiple medications was more common among patients who had drug problems, increasing the healthcare ramifications. The importance of these results lies in the need for comprehensive evaluation and data analysis to assist healthcare providers in making appropriate evidence-based decisions.
Factors Influencing Drug Problems
The study indicates that several factors significantly affect the occurrence of drug problems among patients. Among these factors, anemia was identified as a major risk factor, along with the average number of prescribed medications. Age, gender, and the duration of hospitalization also play a discussable role in increasing the likelihood of drug problems. It is vital for healthcare providers to understand these factors so they can improve treatment strategies and reduce medication-related risks.
The Importance of Pharmaceutical Care Services in Reducing Drug Problems
Pharmaceutical care services represent a critical step in reducing the incidence of drug problems. This requires effective communication between physicians and pharmacists to ensure that all medications are used appropriately. Pharmaceutical care providers offer effective support in evaluating and reviewing medications through direct communication with patients and reviewing their medication records. This type of service emphasizes the importance of following correct treatment protocols, enhancing patient safety, and reducing drug interactions.
Conclusions
The Study and Future Perspectives
The study highlights the importance of recognizing medication problems in patients with kidney diseases. This points to an urgent need to improve education and training for healthcare providers on managing kidney patients and their associated medication issues. Given the observed data, it seems crucial to provide ongoing support programs and enhance communication between medication teams to ensure that healthcare services are delivered optimally. The next phase requires a greater focus on research and the importance of knowledge exchange to achieve real improvement in patient care and their therapeutic journey.
Introduction to Medication-Associated Problems in Kidney Diseases
Medication-related problems (DRPs) are significant health challenges faced by patients, particularly in groups suffering from chronic illnesses such as kidney failure. These problems contribute to the worsening of health conditions and lead to an increased risk of anemia and ineffective medical care. DRPs are defined as any event or circumstance associated with the use of medication that poses a risk to patients, such as improper use of medications or failure to achieve the required clinical objectives. Recognizing these issues and analyzing data from participating patients can lead to improved healthcare delivery.
The Relationship Between DRPs and Anemia
Studies have shown that patients with medication-related problems suffer more from anemia compared to patients who do not have such issues. For example, figures indicate that 43.18% of patients with DRPs are suffering from anemia, while the percentage among those who do not suffer from it is 28.72%. Kidney failure involves a complex medication regimen, especially those related to anemia management, such as iron-containing medications, which cause more adverse interactions. Managing this anemia requires the use of multiple medications, and a lack of coordination in medication can exacerbate the condition.
Causes of DRPs in Patients with Kidney Diseases
Data indicates that the main causes of medication problems in kidney patients relate to treatment safety and efficacy. 60.61% of cases were related to treatment safety, and 26.52% were related to drug efficacy, indicating the importance of careful monitoring of medication prescriptions. It is certain that the lack of professional oversight is a risk factor in the treatment environment. Patients may alter doses unauthorized, leading to greater risks. Psychology and economics have a significant impact on patient behavior regarding their medication use. For instance, some patients may avoid taking medications due to their cost, negatively affecting their health.
Interventions to Address DRPs
When dealing with DRPs, several interventions have been implemented by clinical pharmacists to reduce the rates of these issues. A total of 128 interventions were carried out, with an acceptance rate of 100% for these interventions. These interventions included dose adjustments and providing patient education regarding medications. Research shows that pharmacists’ interventions can represent a turning point in improving treatment outcomes for patients. Communication skills and simplifying information for patients play a crucial role in increasing patient acceptance of treatment and enhancing adherence rates.
Risk Assessment Associated with DRPs
The risks associated with DRPs have been categorized and assessed to understand the potential consequences of these issues. Data illustrates that more than half of the cases require close monitoring, a sign of the importance of having continuous monitoring mechanisms in place. It is important for both doctors and pharmacists to take responsibility for managing and reducing these risks. A good understanding of the potential risks helps improve the quality of healthcare provided to patients. These risks can lead to dire outcomes, such as increased healthcare visits or even hospital admissions, thereby impacting the quality of life for patients.
Challenges
Future Perspectives
With the increasing number of patients experiencing medication-related problems, there is a pressing need for effective strategies to improve the situation. Future studies should include more social and economic factors to better understand the impact on medication use. Simplifying medication information and making it accessible to a wide range of patients, along with training programs for doctors and pharmacists, can help reduce rates of DRPs. Collaboration among healthcare providers and creating effective support environments can contribute to improving patients’ quality of life and reducing the burdens on the healthcare system.
Medication-Related Risks in Kidney Patients
Studies indicate that kidney patients experience medication-related problems (DRPs) increasingly, resulting from the complexities of their health conditions. A combination of chronic diseases such as diabetes and hypertension often accompanies kidney diseases, requiring them to use multiple medications frequently. This intersection of drugs leads to an increased chance of drug interactions, which can have serious consequences for patients’ health. The need to adjust dosages according to kidney function makes it essential for doctors and pharmacists to work together to ensure the safe and effective use of medications.
Research suggests that factors associated with the emergence of DRPs include the severity of chronic kidney disease, length of hospital stay, number of medications taken, age, and gender. Two studies conducted on kidney patients have shown that medication problems increase particularly in the early to middle stages of the disease. This increase poses a significant economic burden on the healthcare system, necessitating effective measures to reduce these issues and increase awareness of them.
Medication problems can also include unwanted interactions or serious side effects, potentially worsening the patient’s health or even leading to hospital readmission. Therefore, understanding these risks is a fundamental part of healthcare for patients with kidney conditions.
The Importance of Medication Reconciliation
Medication reconciliation (MR) is a standardized pharmaceutical service aimed at comparing current medication therapies with prescribed medication orders. This process ensures that all medications a patient is taking are correctly prescribed and align with their therapeutic needs. According to studies, medication reconciliation managed by clinical pharmacists shows lower error rates compared to doctors, contributing to the preservation of healthcare resources and ensuring the accuracy of medication therapy.
In the field of managing kidney diseases, medication reconciliation is crucial due to changes resulting from kidney functions. When kidneys experience reduced function, accurately adjusting dosages becomes vital since the use of incorrect dosages may worsen the health condition. By effectively implementing medication reconciliation, the occurrence of DRPs can be reduced, which in turn improves patient safety and quality of care. Pharmacy teams in kidney units can play a significant role in this regard, leading to safer and more effective treatments.
The medication reconciliation process requires collaboration between doctors and pharmacists, where pharmacists support the information provided by doctors with evidence-based data. Moreover, appropriate training for pharmacists in this field is essential to ensure the success of these processes. Studies have shown that positive interaction between medical teams increases pharmacists’ acceptance of their practices and their contributions to patient care.
Response of Doctors and Patients to Pharmacist Interventions
Data indicates that pharmacist interventions in managing medications are well accepted by both doctors and patients. Healthcare professionals collaborate to improve patient outcomes by enhancing their understanding of the importance of using medications correctly. Doctors respond positively to pharmacists, and patients express their appreciation for the support they receive regarding medication problems.
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The acceptance of pharmacists’ interventions by physicians indicates an increased awareness of the important role that pharmacists play in patient care. This collaboration is not only reflected in the provision of medications but also extends to offering knowledge and support on how to manage daily treatments. By enhancing medical information, pharmacists can contribute to raising patients’ awareness about using their medications more effectively.
Experimental studies show that participants in medication reconciliation programs report a significant improvement in their knowledge of treatment and in managing their health conditions. Pharmacists, when conducting specialized training programs, can provide accurate and well-explained interpretations of their medication-related issues and how to address them, thereby enhancing patients’ adherence to treatment.
Future Challenges in Clinical Pharmacy
The pharmaceutical field faces ongoing challenges, including the need to improve the quality of services provided. There is an urgent need to develop precise and standardized working mechanisms to ensure continuity of care and improve patient outcomes. Additionally, efforts must be made to build a database representing all information related to medications, including effects and potential interactions. This data will be essential in developing strategies for patient care and avoiding medication-related problems.
Furthermore, the field of clinical pharmacy requires more research and studies focusing on the various contexts that can affect treatment outcomes. Studies should be conducted on a large scale, including a representative sample of the community to be able to provide generalizable and broadly applicable results. Therefore, greater collaboration is required between educational institutions, research, and practitioners to provide integrated healthcare.
Technological innovation continues to offer new opportunities in the field of clinical pharmacy. By utilizing artificial intelligence and data science techniques, the medication reconciliation process and risk-benefit analyses can be performed faster and more accurately. The introduction of technology into both daily practice and training will play a crucial role in shaping the future of healthcare.
Study Methodology
The study methodology is the cornerstone of obtaining reliable and meaningful results, with work beginning by conducting a comprehensive assessment of patients’ medical and medication history 48 hours after their admission to the nephrology department. The clinical pharmacist collected all information related to the medications the patient is taking, including names, details, dosages, and serious complications. This was done through interviews with patients and their families, which helped assess patients’ adherence to their medications and identify any treatment-related issues. Additionally, the Chronic Kidney Disease Management Guide was updated to include a comprehensive list of medication names, purposes, and dosages. This information allows the pharmacist to review and facilitate the improvement of treatment plans, focusing on the interaction between the pharmacist and patients to deliver better care.
Assessment of Medication Adherence
The Morisky scale was used to assess adherence to treatment, consisting of 8 questions that help evaluate the patient’s behavior towards using their medications. A patient scoring 8 points received a good adherence rating, while lower scores received moderate or poor ratings. Thus, it is possible to identify groups that need additional support to ensure correct medication use. This tool is specific and vital, as it represents a clear indicator of potential non-adherence by patients, which could negatively impact therapeutic outcomes. Consequently, there is a need to analyze the results to implement appropriate interventions to improve adherence levels.
Classification of Medication-Related Problems
A new classification of medication-related problems was developed to fit the Chinese healthcare environment. The known potential risk assessments of medication problems were integrated with traditional medication issues classifications, providing a comprehensive view of many aspects related to treatment. Through this classification, the pharmacist was able to accurately identify the causes of problems and provide effective solutions. Six aspects were identified, including the problem, cause, intervention, acceptance, status, and assessment of potential risks associated with the problems. This integration is an important step in developing a strategy for managing medication problems, as it helps build a closed system to ensure follow-up and improve health support for patients.
Analysis
Statistical Data
The SPSS statistical software suite was used to analyze the data, with results reflecting precise analytical procedures. The complete explanation of the statistics used aids in understanding patterns and trends, including how medication issues affect different types of patients. Researchers employed various tests to demonstrate the relationship between variables and the ability of adherence indicators to predict medication problems. These analyses paint a clear picture of the factors influencing the relationship between patients and their medications, leading to results that underscore the importance of continuous care and effective communication between patients and healthcare staff.
Study Results
The study included 623 patients, providing a comprehensive overview of the patient system in the nephrology department. Results showed that 21.8% of patients experienced medication-related issues, with this percentage being higher among patients over 65 years old. This indicates that older age groups were more susceptible to medication problems due to multiple factors such as the number of prescribed medications and previous illnesses. The study also found that patients classified under certain categories of chronic kidney disease were more likely to encounter medication issues. These results reaffirm the importance of continuous monitoring of clinical drivers and medication problems to reduce risks and enhance the quality of healthcare provided.
Types of Interventions and Agreement on Treatment Plans
The study implemented 128 interventions by the clinical pharmacist to improve medication management for patients. Notably, the acceptance rate of these interventions among patients reached 100%, indicating good understanding and satisfaction with the changes made. These interventions provide an opportunity for patients to effectively participate in their treatment plans, leading to improved clinical outcomes overall. Hence, patient counseling and assistance programs are fundamental in enhancing treatment safety and medication adherence, as the study shows that good communication and patient understanding of their circumstances lead to a notable improvement in health status.
Assessment of Potential Risks of Medication Issues
The potential risks of medication issues were assessed in 78 out of 132 identified cases. Results showed that most of these risks fall within category C, highlighting the need for ongoing review of the costs involved in pharmaceutical uses. These assessments underscore the importance of organization and continuous development of treatment plans to ensure the provision of the safest and most efficient care. This comprehensive risk assessment can help enhance clinical pharmacy practices and limit negative incidents in the future.
Medication Issues Related to Patients with Kidney Diseases
Chronic diseases, especially kidney diseases, face numerous medication-related issues that significantly impact patients’ health levels and quality of life. According to data inferred from the study, a large percentage of patients take medications incorrectly, exacerbating their health conditions and increasing the risk of complications. For example, patients taking iron and calcium supplements together at inappropriate times may negatively affect the absorption of these nutrients. Additionally, financial behaviors sometimes affect patients’ adherence to medication doses, as some tend to reduce doses in a bid to cut costs, without consulting their doctors.
The study indicates that 38.35% of medication-related cases are linked to prescription errors, reflecting the importance of considering how to select medications and their doses, particularly for patients suffering from kidney diseases. It is essential for physicians to review current prescriptions to ensure they reflect the specific needs of each patient, which requires strong mechanisms for reviewing and verifying the efficacy of medications. Problems arising from improper therapeutic actions may lead physicians to believe that current medications are ineffective, hindering treatment progress and resulting in severe consequences for patients’ health.
Importance
Education and Medication Awareness
The process of education and awareness about medications plays a crucial role in enhancing treatment adherence. According to the study, patient-level interventions led to a significant success rate in resolving medication-related issues, as patients showed a high acceptance of these recommendations. Educating patients on how to use certain medications, and understanding potential side effects, helps them make satisfactory decisions regarding their treatments, thus improving treatment outcomes. These results highlight the importance of enhancing medication education as part of patient care in hospitals.
Additionally, it appears that interventions conducted by clinical pharmacists were fully accepted by physicians, reflecting the importance of collaborative work between doctors and pharmacists to ensure the best possible medical care is provided. Emphasizing this partnership can lead to a reduction in medication-related errors and improve drug safety for patients, contributing to an enhanced quality of life for those suffering from chronic diseases.
Challenges in Kidney Patient Care and Economic Impacts
The rate of occurrence of medication-related problems (DRPs) among patients with kidney diseases is considered a significant challenge, as it is associated with mortality rates, acute complications, and morbidity. In light of these cases, it is crucial to identify the factors that influence the occurrence of these problems, such as renal anemia and the average number of medications taken. The large number of medications a patient takes may increase the risk of encountering medication-related issues, necessitating extra care in prescribing and managing medications.
As countries strive to improve their healthcare systems, attention should be given to investing in training programs for kidney patient care and implementing effective strategies to enhance medication management. Platforms should be utilized to exchange information about medications and facilitate discussions between doctors and pharmacists, as coordination between these parties is vital for allowing patients to receive appropriate treatment and avoid medical errors.
Risk Analysis, Outcomes, and Future Recommendations
It is important to conduct comprehensive risk analyses related to medication-associated problems. Although 86.36% of the cases trained did not harm patients, there is a certain percentage that requires careful monitoring. This necessitates integration between doctors and pharmacists in medication reviews to effectively monitor patients, alongside providing a notification system that encourages patients to report any undesirable symptoms that may arise during treatment.
The future of information technology in healthcare should be leveraged to support these initiatives. Regular screenings and ongoing research into the effectiveness of medications and treatment outcomes will contribute to enhancing drug safety. Research should be incorporated into continuous improvement strategies to ensure the best possible results for patients suffering from chronic diseases. It is also vital to consider other variables, such as lifestyle, education, and length of hospital stay in future analyses, to gain a deeper understanding of the factors affecting treatment adherence.
Source link: https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1436561/full
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