Role of Pharmacist Interventions in Drug Related Problem among Chronic Kidney Disease Patients

Abstract:

Background: Chronic kidney disease is a longstanding disease which leads to gradual loss of kidney function causing renal failure. Although medications are more effective, Increase in the number of drugs can lead to various drug related problems. Our study aims to identify the most common DRPs in chronic kidney disease patients. Materials and Methods: A prospective observational study done in the Department of Nephrology, PSG Hospital, Coimbatore, India (n=148). The patients were regularly followed up, drug related problems were identified, reported to the physician and assessed using Pharmaceutical Care Network Europe while Naranjo scale was used to identify adverse reactions. Chi -square test was used to analyze the data. Results: A total of 148 patients were enrolled for the study. 62.8% males and 37.6% females. 28% were of the age group between 60-69 years while 2% were of age above 80 years. By use of Pharmaceutical Care Network Europe scale, the identified problems were categorized under treatment effectiveness (65%), others (24%) and treatment safety (11%). The most predominant drug related problem was drug interactions under treatment effectiveness. The major causes associated with the problems were found to be drug selection (28%), dose selection (22%), drug use process (22%), treatment duration (2%), others (26%). Chi-square test was used to find the correlation between stages of chronic kidney disease and poly-pharmacy, it was found to be statistically significant. Association between co-morbid conditions and drug related problems were found to be statistically significant. Conclusion: It is important to identify drug related problems to avoid further complications and progression of the disease. A total of 54 drug related problem were identified by reviewing medication charts. Various parameters like social habits, poly-pharmacy and co-morbid conditions have significant association with drug related problems. Therefore, healthcare professionals, caregivers and patients should work together to avoid drug related problems and improving quality of life.

Keywords: CKD, Drug-related problem, ADRs, PCNE, Poly-pharmacy.