Introduction:
Drug-related problems (DRPs) are considered one of the major challenges in healthcare, particularly within the nephrology department, where managing kidney patients requires polypharmacy and a delicate balance in prescribing therapy. In this context, we aim to explore the prevalence of DRPs and the influencing factors among hospitalized kidney patients to study their impact on patient safety and drug effectiveness. This article discusses data collected from 623 patients in the nephrology department over a specified period, using a modified classification of drug problems. The article presents the results of the statistical analysis and provides insights into how pharmaceutical care can be improved for these patients, reflecting the importance of pharmacists in reducing treatment-related risks and ensuring the safe and effective use of medications.
Introduction to Drug Problems in Kidney Patients
The nephrology department is one of the complex medical fields that requires special attention when using medications. Patients with kidney diseases often suffer from accompanying complications, such as hypertension and diabetes, which complicate the patient’s condition. This necessitates 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 the need for monitoring patients to ensure effective and safe treatment. Drug-related problems, which refer to any issues related to the safe and effective use of medications, are very common in kidney patients across various stages of their disease. This makes evaluating these problems a necessary step in improving patient care.
Research Methods and Approaches Used
Information was collected from department patients through a comprehensive study extending over the period from October 2020 to September 2021. The focus was on assessing patient information, including medical history and prescribed medications. The modified version of the drug problems classification based on the PCNE classification was adopted as a tool for evaluating and analyzing potential problems. The research team employed multiple methods, including assessment through questionnaires and data aggregation to determine the prevalence of drug-related problems and the associated risk factors. The use of a multiple binary statistical analysis model was essential for measuring the rate of risk and drug-related problems pertinent to the patient.
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 suffering from drug-related problems, representing 21.8%. The incidence of anemia was particularly evident in these patients, as the groups with drug-related problems experienced a higher rate of anemia compared to patients who did not face such issues. Additionally, the use of multiple medications was more prevalent among patients who suffered from drug problems, which increases healthcare burdens. The significance of these findings lies in the need for comprehensive evaluation and data analysis to assist healthcare providers in making appropriate, evidence-based decisions.
Factors Influencing the Occurrence of Drug Problems
The study indicates that several factors significantly influence the occurrence of drug-related problems among patients. Among these factors, anemia was identified as a primary risk factor, along with the average number of prescribed medications. Age, gender, and the length of hospital stay also play a discussable role in increasing the likelihood of drug-related problems. It is important for healthcare providers to understand these factors to enhance treatment strategies and reduce drug-related risks.
The Importance of Pharmaceutical Care Services in Reducing Drug Problems
Pharmaceutical care services represent a fundamental step in reducing the incidence of drug-related problems. This requires effective partnerships for communication between doctors and pharmacists to ensure that all medications are used appropriately. Pharmacists provide 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, thereby enhancing patient safety and reducing drug interactions.
Conclusions
Study and Future Prospects
The study highlights the importance of recognizing drug-related problems in patients suffering from renal diseases. This indicates an urgent need to improve education and training for healthcare providers on managing kidney patients and their associated drug issues. Considering the observed data, it seems essential to provide ongoing support programs and enhance communication between medical teams concerning medications to ensure optimal healthcare services. The next phase requires a greater focus on research and the significance of knowledge exchange to achieve real improvement in patient care and their treatment journeys.
Introduction to Drug-Related Problems Associated with Renal Diseases
Drug-related problems (DRPs) are major health challenges faced by patients, especially in groups suffering from chronic diseases 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 condition related to the use of medications that poses a risk to patients, such as inappropriate medication use or failure to achieve the required clinical objectives. Identifying these problems and analyzing the data of participating patients can lead to improved healthcare delivery.
The Relationship Between DRPs and Anemia
Studies have shown that patients with drug-related problems are more likely to suffer from anemia compared to those who do not have such issues. For example, figures indicate that 43.18% of patients with DRPs are affected by anemia, whereas the rate among those without anemia is 28.72%. Kidney failure involves a complex system of medications, especially those associated with anemia treatment, such as iron-containing medications, which cause more adverse interactions. Addressing this anemia requires the use of multiple medications, and lack of coordination in these drugs can exacerbate the condition.
Causes of DRPs in Patients with Kidney Diseases
Data indicates that the main causes of drug-related problems in kidney patients relate to the safety and effectiveness of treatment. 60.61% of cases were associated with treatment safety, and 26.52% were related to medication effectiveness, highlighting the importance of meticulous monitoring of medication prescriptions. It is certain that the absence of professional supervision is a risk factor in the treatment environment. Patients may modify dosages unauthorized, leading to greater risks. Psychological and economic factors significantly influence patients’ behavior in using their medications. For instance, some patients may avoid taking medications due to their cost, negatively affecting their health.
Interventions to Address DRPs
In dealing with DRPs, a number of interventions have been implemented by clinical pharmacists to reduce the rates of these problems. 128 interventions were performed, with a 100% acceptance rate for these interventions. These interventions included dosage adjustments and providing patients with instructions about their 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.
Assessment of Risks Associated with DRPs
The risks associated with DRPs were classified and assessed to understand the potential consequences of these problems. Data indicates that more than half of the cases require careful monitoring, marking the importance of having continuous monitoring mechanisms. It is important for both doctors and pharmacists to take responsibility in managing and minimizing these risks. A good understanding of potential risks helps improve the quality of healthcare provided to patients. These risks may lead to severe outcomes, such as increased healthcare visits or even hospitalization, thus affecting the quality of life for patients.
Challenges
Future Perspectives
With the increasing number of patients experiencing medication-related problems, there is a growing need for effective strategies to improve the situation. Future studies should incorporate 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, alongside 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 alleviating burdens on the healthcare system.
Medication-Related Risks in Kidney Patients
Studies indicate that kidney patients increasingly suffer from medication-related problems (DRPs), often as a result of the complexities of their health conditions. A range of chronic diseases, such as diabetes and hypertension, often accompany kidney diseases, requiring them to use multiple medications frequently. This intersection of medications increases the likelihood of drug interactions, which can have serious consequences on patient 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 shows 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 demonstrated that medication problems increase particularly in stages one to four of the disease. This rise poses a significant economic burden on the healthcare system, necessitating effective measures to reduce these issues and raise awareness about them.
Medication problems can also include unwanted interactions or serious side effects, and can exacerbate the patient’s health condition or even lead to readmission to the hospital. Therefore, understanding these risks is a fundamental part of healthcare for patients with kidney conditions.
Importance of Medication Reconciliation
Medication reconciliation (MR) is a standard pharmaceutical service aimed at aligning the patient’s current medications with the prescribed medication orders. This process ensures that all medications taken by the patient are appropriately prescribed and align with their therapeutic needs. According to studies, medication reconciliations managed by clinical pharmacists show lower error rates compared to physicians, contributing to the maintenance of health resources and ensuring the accuracy of pharmacotherapy.
In the field of managing kidney diseases, medication reconciliation is crucial due to the changes resulting from kidney function. When the kidneys experience a decline in function, it becomes vital to adjust dosages accurately, as using incorrect dosages may worsen the patient’s 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 respect, leading to the provision of safer and more effective treatments.
The medication reconciliation process requires collaboration between doctors and pharmacists, with pharmacists supporting the information provided by physicians with evidence-based data. Furthermore, appropriate educational training for pharmacists in this field is essential to ensure the success of these processes. Studies have shown that positive interaction among medical teams increases pharmacists’ acceptance of their practices and their contributions to patient care.
Responses of Physicians and Patients to Pharmacist Interventions
Data suggests that pharmacist interventions in medication management are generally well-received by both physicians and patients. Healthcare professionals collaborate to improve patient outcomes by enhancing their understanding of the importance of proper medication use. Physicians respond positively to pharmacists, and patients express their appreciation for the support they receive regarding medication issues.
The
Acceptance of interventions by pharmacists by doctors indicates an increasing awareness of the important role pharmacists play in patient care. This collaboration is not only reflected in providing medications but also extends to offering knowledge and support in managing 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 feel a significant improvement in their understanding of treatment and in managing their health conditions. When pharmacists undertake specialized training programs, they can provide accurate and better-explained interpretations of medication-related issues and how to address them, thereby enhancing patients’ adherence to treatment.
Future Challenges in Clinical Pharmacy
The pharmacy field faces ongoing challenges, including the need to improve the quality of services provided. There is a pressing 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 medication-related information, including effects and potential interactions. This data will be essential in developing strategies for patient care and avoiding medication-related problems.
Moreover, the clinical pharmacy specialty requires more research and studies that focus on the different contexts that may affect treatment outcomes. Studies should be conducted on a large scale that includes a sample representing the community to be capable of providing generalizable and broadly applicable results. Therefore, greater collaboration among educational and research institutions and practitioners is required to provide comprehensive healthcare.
Technological innovation continues to offer new opportunities in the field of clinical pharmacy. By using artificial intelligence and data science techniques, the medication reconciliation process can be improved, analyzing risks and benefits more quickly and accurately. The introduction of technology in both daily practice and training will play an effective role in shaping the future of healthcare.
Study Methodology
The study methodology is the cornerstone of obtaining reliable and meaningful results, starting with a comprehensive assessment of the patients’ medical and medication history 48 hours after their admission to the kidney department. The clinical pharmacist gathered all information related to the medications the patient was taking, including names, details, dosages, and serious complications. This was done through interviews with patients and their families, helping evaluate patients’ adherence to their medications and identifying any treatment-related issues. Additionally, the chronic kidney disease management guide was updated to include a comprehensive list of medications, purposes, and dosages. This information allows the pharmacist to review and facilitate the optimization of treatment plans, focusing on the interaction between the pharmacist and patients to provide better care.
Assessment of Adherence to Medications
The Morisky scale was used to measure adherence to treatment, consisting of 8 questions, which helps assess the patient’s behavior towards their medication use. A patient scoring 8 points received a good adherence rating, while lower scores received moderate or poor ratings. Thus, it’s possible to determine the groups needing additional support to ensure proper medication use. This tool is particularly vital as it represents a clear indicator of potential non-adherence by patients, which may negatively affect treatment outcomes. Consequently, it requires analyzing results to implement appropriate interventions to improve adherence levels.
Classification of Medication Issues
A new classification of medication issues has been developed to suit the Chinese healthcare environment. It integrates the assessment of known potential risks associated with medication issues with traditional classifications of medication problems, providing a comprehensive view of various aspects related to treatment. Through this classification, pharmacists were able to accurately identify the causes of problems and provide effective solutions. Six dimensions were identified, including the issue, cause, intervention, acceptance, status, and assessment of potential risks of the problems. This integration is a significant step in developing a strategy for managing medication issues, helping to build a closed system to ensure follow-up and improve health support for patients.
Analysis
Statistical Analysis of Data
The SPSS statistical software package was used for data analysis, where the results reflected precise analytical procedures. A full explanation of the statistics used helps in understanding the patterns and trends, including how medication issues affect different types of patients. Researchers employed various tests to demonstrate the relationship between variables and the predictive ability of adherence indicators regarding medication problems. These analyses paint a clear picture of the factors influencing the relationship between patients and their medications, leading to results that affirm the importance of ongoing care and effective communication between patients and healthcare providers.
Study Results
The study included 623 patients, providing a comprehensive overview of the patient system in the nephrology department. The results showed that 21.8% of patients experienced medication-related problems, with this percentage being higher among patients over the age of 65. 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 revealed that patients categorized within certain stages of chronic kidney disease were more prone to medication issues. These findings underscore the importance of continuous monitoring of clinical drivers and medication problems to reduce risks and improve the quality of healthcare provided.
Types of Interventions and Approval of Treatment Plans
The study implemented 128 interventions by the clinical pharmacist to improve medication management for patients. It was noteworthy that the patient acceptance rate for these interventions reached 100%, indicating a good understanding and satisfaction of patients regarding the changes made. These interventions provide an opportunity for patients to actively participate in their treatment plans, resulting in overall improved clinical outcomes. Therefore, guidance and patient assistance programs are essential for enhancing treatment safety and medication adherence, as the study shows that good communication and patient understanding of their condition lead to significant health improvements.
Assessment of Potential Risks of Medication Problems
The potential risks of medication problems were assessed in 78 out of 132 identified cases. The results showed that the majority of these risks fell within category C, highlighting the need for continuous review of the costs involved in medication uses. These assessments illustrate the importance of organizing and continuously developing treatment plans to ensure the provision of the safest and most efficient care. This comprehensive risk evaluation can help enhance clinical pharmacy practices and reduce negative incidents in the future.
Medication Issues Related to Patients with Kidney Diseases
Chronic diseases, particularly kidney diseases, face numerous medication-related issues that significantly impact patients’ health and quality of life. According to data drawn from the study, a large percentage of patients are improperly taking medications, exacerbating their health conditions and increasing the risk of complications. For instance, patients taking medications like iron and calcium together at inappropriate times may negatively affect the absorption of these nutrients. Additionally, financial behaviors can sometimes impact patients’ adherence to medication dosages, as some may reduce their dosages in search of cost reduction without consulting their doctors.
The study indicates that 38.35% of medication-related cases are associated with prescription errors, reflecting the importance of considering how medications and their dosages are chosen, especially for patients with kidney diseases. It is essential for doctors to review current prescriptions to ensure they reflect the specific needs of each patient, requiring strong mechanisms for reviewing and verifying the effectiveness of medications. Problems arising from incorrect treatment behaviors may lead doctors to believe that current medications are ineffective, hindering treatment progress and leading to dire consequences for patients’ health.
Importance
Education and Disease 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 addressing medication-related problems, as patients showed great acceptance of these recommendations. Educating patients on how to use specific drugs and understanding potential side effects helps them make informed decisions about their treatments, thereby improving treatment outcomes. These results highlight the importance of enhancing medication education as part of patient care in hospitals.
Additionally, it appears that interventions carried out by clinical pharmacists were fully accepted by physicians, reflecting the importance of collaboration between doctors and pharmacists to ensure the best possible medical care. Emphasizing this partnership can reduce medication-related errors and improve medication safety for patients, contributing to an enhanced quality of life for those suffering from chronic illnesses.
Challenges in Kidney Patient Care and Economic Impacts
The incidence of drug-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 essential to identify the factors influencing 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 drug-related problems, necessitating extra care in prescribing and managing medications.
In the context of countries striving to improve healthcare systems, investment in training programs for kidney patient care and implementing effective strategies to enhance medication management should be considered. Platforms for sharing information about medications and facilitating discussions between doctors and pharmacists should be utilized, as coordination among these parties is vital for allowing patients to receive appropriate treatment and avoid medical errors.
Risk Assessment, Outcomes, and Future Recommendations
It is important to conduct comprehensive risk assessments related to medication-associated issues. Although 86.36% of cases were trained not to harm patients, a certain percentage necessitates close monitoring. This requires integration between doctors and pharmacists in medication reviews to effectively monitor patients, alongside providing a notification system that encourages patients to report any adverse 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 medication efficacy and treatment outcomes will contribute to enhancing drug safety. Research should be included in continuous improvement strategies to ensure the best possible outcomes for patients suffering from chronic diseases. It is also crucial to consider other variables, such as lifestyle, education, and hospital stay duration 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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