Identification of drug-related problems in ambulatory chronic kidney disease patients: a 6-month prospective study. Belaiche, S., Romanet, T., Allenet, B., Calop, J., & Zaoui, P. Journal of Nephrology, 25(5):782–788, October, 2012. doi abstract bibtex BACKGROUND: Drug-related problems (DRPs) are common in chronic kidney disease (CKD) patients. We developed a 2-step consultation including a clinical pharmacist (CP) session and a nephrologist conventional care consultation to explore the feasibility of a pilot drug-oriented disease management program in controlling iatrogenic side effects. METHODS: Drug inventory was estimated by a CP before each nephrology consultation. CP interventions were based on the French Society of Clinical Pharmacy intervention tools. RESULTS: In this 6-month prospective study, 67 CKD patients were enrolled: 77% with stage 3 or 4 CKD (by Kidney Disease Improving Global Outcomes criteria), 66% males, 76% with diabetes, median age 70 years (range 59-75), with a mean 2.6 ± 1.2 comorbidities and 10 ± 3.5 medications. We registered 142 DRPs, in 93% of patients, which mainly concerned untreated indications (31.7%) and incorrect dosages (19%). The most frequent pharmaceutical interventions concerned addition of drug (34%) and adaptation of dose (25.5%). The main drugs involved concerned the cardiovascular (33%), digestive-metabolic (26.9%) and hematopoietic (19.9%) systems. DRPs correlated significantly with a higher number of medications (p=0.049) and with older patient age (p=0.0027). Furthermore, patients' knowledge was evaluated in 41 patients (61%) by the CP with a systematic questionnaire. Three at-risk situations were described: 80.5% of patients interviewed were unaware of the beneficial impact of their treatment, 85% were not aware of medical situations at risk and 68% declared self-medication habits. CONCLUSION: A formatted CP evaluation coupled with a renal consultation was able to detect a higher level of DRPs, to reinforce educational messages and to propose immediate changes in the therapeutic project.
@article{belaiche_identification_2012,
title = {Identification of drug-related problems in ambulatory chronic kidney disease patients: a 6-month prospective study},
volume = {25},
issn = {1724-6059},
shorttitle = {Identification of drug-related problems in ambulatory chronic kidney disease patients},
doi = {10.5301/jn.5000063},
abstract = {BACKGROUND: Drug-related problems (DRPs) are common in chronic kidney disease (CKD) patients. We developed a 2-step consultation including a clinical pharmacist (CP) session and a nephrologist conventional care consultation to explore the feasibility of a pilot drug-oriented disease management program in controlling iatrogenic side effects.
METHODS: Drug inventory was estimated by a CP before each nephrology consultation. CP interventions were based on the French Society of Clinical Pharmacy intervention tools.
RESULTS: In this 6-month prospective study, 67 CKD patients were enrolled: 77\% with stage 3 or 4 CKD (by Kidney Disease Improving Global Outcomes criteria), 66\% males, 76\% with diabetes, median age 70 years (range 59-75), with a mean 2.6 ± 1.2 comorbidities and 10 ± 3.5 medications. We registered 142 DRPs, in 93\% of patients, which mainly concerned untreated indications (31.7\%) and incorrect dosages (19\%). The most frequent pharmaceutical interventions concerned addition of drug (34\%) and adaptation of dose (25.5\%). The main drugs involved concerned the cardiovascular (33\%), digestive-metabolic (26.9\%) and hematopoietic (19.9\%) systems. DRPs correlated significantly with a higher number of medications (p=0.049) and with older patient age (p=0.0027). Furthermore, patients' knowledge was evaluated in 41 patients (61\%) by the CP with a systematic questionnaire. Three at-risk situations were described: 80.5\% of patients interviewed were unaware of the beneficial impact of their treatment, 85\% were not aware of medical situations at risk and 68\% declared self-medication habits.
CONCLUSION: A formatted CP evaluation coupled with a renal consultation was able to detect a higher level of DRPs, to reinforce educational messages and to propose immediate changes in the therapeutic project.},
language = {eng},
number = {5},
journal = {Journal of Nephrology},
author = {Belaiche, Stéphanie and Romanet, Thierry and Allenet, Benoît and Calop, Jean and Zaoui, Philippe},
month = oct,
year = {2012},
pmid = {22322820},
keywords = {Age Factors, Aged, Ambulatory Care, Comorbidity, Cooperative Behavior, Drug-Related Side Effects and Adverse Reactions, Feasibility Studies, Female, France, Health Knowledge, Attitudes, Practice, Hospitals, University, Humans, Iatrogenic Disease, Interdisciplinary Communication, Male, Medication Reconciliation, Middle Aged, Patient Care Team, Patient Education as Topic, Pharmacists, Pharmacy Service, Hospital, Pilot Projects, Polypharmacy, Program Evaluation, Prospective Studies, Referral and Consultation, Renal Insufficiency, Chronic, Self Medication, Severity of Illness Index, Surveys and Questionnaires, Time Factors},
pages = {782--788}
}
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We developed a 2-step consultation including a clinical pharmacist (CP) session and a nephrologist conventional care consultation to explore the feasibility of a pilot drug-oriented disease management program in controlling iatrogenic side effects. METHODS: Drug inventory was estimated by a CP before each nephrology consultation. CP interventions were based on the French Society of Clinical Pharmacy intervention tools. RESULTS: In this 6-month prospective study, 67 CKD patients were enrolled: 77% with stage 3 or 4 CKD (by Kidney Disease Improving Global Outcomes criteria), 66% males, 76% with diabetes, median age 70 years (range 59-75), with a mean 2.6 ± 1.2 comorbidities and 10 ± 3.5 medications. We registered 142 DRPs, in 93% of patients, which mainly concerned untreated indications (31.7%) and incorrect dosages (19%). The most frequent pharmaceutical interventions concerned addition of drug (34%) and adaptation of dose (25.5%). The main drugs involved concerned the cardiovascular (33%), digestive-metabolic (26.9%) and hematopoietic (19.9%) systems. DRPs correlated significantly with a higher number of medications (p=0.049) and with older patient age (p=0.0027). Furthermore, patients' knowledge was evaluated in 41 patients (61%) by the CP with a systematic questionnaire. Three at-risk situations were described: 80.5% of patients interviewed were unaware of the beneficial impact of their treatment, 85% were not aware of medical situations at risk and 68% declared self-medication habits. CONCLUSION: A formatted CP evaluation coupled with a renal consultation was able to detect a higher level of DRPs, to reinforce educational messages and to propose immediate changes in the therapeutic project.","language":"eng","number":"5","journal":"Journal of Nephrology","author":[{"propositions":[],"lastnames":["Belaiche"],"firstnames":["Stéphanie"],"suffixes":[]},{"propositions":[],"lastnames":["Romanet"],"firstnames":["Thierry"],"suffixes":[]},{"propositions":[],"lastnames":["Allenet"],"firstnames":["Benoît"],"suffixes":[]},{"propositions":[],"lastnames":["Calop"],"firstnames":["Jean"],"suffixes":[]},{"propositions":[],"lastnames":["Zaoui"],"firstnames":["Philippe"],"suffixes":[]}],"month":"October","year":"2012","pmid":"22322820","keywords":"Age Factors, Aged, Ambulatory Care, Comorbidity, Cooperative Behavior, Drug-Related Side Effects and Adverse Reactions, Feasibility Studies, Female, France, Health Knowledge, Attitudes, Practice, Hospitals, University, Humans, Iatrogenic Disease, Interdisciplinary Communication, Male, Medication Reconciliation, Middle Aged, Patient Care Team, Patient Education as Topic, Pharmacists, Pharmacy Service, Hospital, Pilot Projects, Polypharmacy, Program Evaluation, Prospective Studies, Referral and Consultation, Renal Insufficiency, Chronic, Self Medication, Severity of Illness Index, Surveys and Questionnaires, Time Factors","pages":"782–788","bibtex":"@article{belaiche_identification_2012,\n\ttitle = {Identification of drug-related problems in ambulatory chronic kidney disease patients: a 6-month prospective study},\n\tvolume = {25},\n\tissn = {1724-6059},\n\tshorttitle = {Identification of drug-related problems in ambulatory chronic kidney disease patients},\n\tdoi = {10.5301/jn.5000063},\n\tabstract = {BACKGROUND: Drug-related problems (DRPs) are common in chronic kidney disease (CKD) patients. We developed a 2-step consultation including a clinical pharmacist (CP) session and a nephrologist conventional care consultation to explore the feasibility of a pilot drug-oriented disease management program in controlling iatrogenic side effects.\nMETHODS: Drug inventory was estimated by a CP before each nephrology consultation. CP interventions were based on the French Society of Clinical Pharmacy intervention tools.\nRESULTS: In this 6-month prospective study, 67 CKD patients were enrolled: 77\\% with stage 3 or 4 CKD (by Kidney Disease Improving Global Outcomes criteria), 66\\% males, 76\\% with diabetes, median age 70 years (range 59-75), with a mean 2.6 ± 1.2 comorbidities and 10 ± 3.5 medications. We registered 142 DRPs, in 93\\% of patients, which mainly concerned untreated indications (31.7\\%) and incorrect dosages (19\\%). The most frequent pharmaceutical interventions concerned addition of drug (34\\%) and adaptation of dose (25.5\\%). The main drugs involved concerned the cardiovascular (33\\%), digestive-metabolic (26.9\\%) and hematopoietic (19.9\\%) systems. DRPs correlated significantly with a higher number of medications (p=0.049) and with older patient age (p=0.0027). Furthermore, patients' knowledge was evaluated in 41 patients (61\\%) by the CP with a systematic questionnaire. Three at-risk situations were described: 80.5\\% of patients interviewed were unaware of the beneficial impact of their treatment, 85\\% were not aware of medical situations at risk and 68\\% declared self-medication habits.\nCONCLUSION: A formatted CP evaluation coupled with a renal consultation was able to detect a higher level of DRPs, to reinforce educational messages and to propose immediate changes in the therapeutic project.},\n\tlanguage = {eng},\n\tnumber = {5},\n\tjournal = {Journal of Nephrology},\n\tauthor = {Belaiche, Stéphanie and Romanet, Thierry and Allenet, Benoît and Calop, Jean and Zaoui, Philippe},\n\tmonth = oct,\n\tyear = {2012},\n\tpmid = {22322820},\n\tkeywords = {Age Factors, Aged, Ambulatory Care, Comorbidity, Cooperative Behavior, Drug-Related Side Effects and Adverse Reactions, Feasibility Studies, Female, France, Health Knowledge, Attitudes, Practice, Hospitals, University, Humans, Iatrogenic Disease, Interdisciplinary Communication, Male, Medication Reconciliation, Middle Aged, Patient Care Team, Patient Education as Topic, Pharmacists, Pharmacy Service, Hospital, Pilot Projects, Polypharmacy, Program Evaluation, Prospective Studies, Referral and Consultation, Renal Insufficiency, Chronic, Self Medication, Severity of Illness Index, Surveys and Questionnaires, Time Factors},\n\tpages = {782--788}\n}\n\n","author_short":["Belaiche, S.","Romanet, T.","Allenet, B.","Calop, J.","Zaoui, P."],"key":"belaiche_identification_2012","id":"belaiche_identification_2012","bibbaseid":"belaiche-romanet-allenet-calop-zaoui-identificationofdrugrelatedproblemsinambulatorychronickidneydiseasepatientsa6monthprospectivestudy-2012","role":"author","urls":{},"keyword":["Age Factors","Aged","Ambulatory Care","Comorbidity","Cooperative Behavior","Drug-Related Side Effects and Adverse Reactions","Feasibility Studies","Female","France","Health Knowledge","Attitudes","Practice","Hospitals","University","Humans","Iatrogenic Disease","Interdisciplinary Communication","Male","Medication Reconciliation","Middle Aged","Patient Care Team","Patient Education as Topic","Pharmacists","Pharmacy Service","Hospital","Pilot Projects","Polypharmacy","Program Evaluation","Prospective Studies","Referral and Consultation","Renal Insufficiency","Chronic","Self Medication","Severity of Illness Index","Surveys and Questionnaires","Time Factors"],"downloads":0},"search_terms":["identification","drug","related","problems","ambulatory","chronic","kidney","disease","patients","month","prospective","study","belaiche","romanet","allenet","calop","zaoui"],"keywords":["age factors","aged","ambulatory care","comorbidity","cooperative behavior","drug-related side effects and adverse reactions","feasibility studies","female","france","health knowledge","attitudes","practice","hospitals","university","humans","iatrogenic disease","interdisciplinary communication","male","medication reconciliation","middle aged","patient care team","patient education as topic","pharmacists","pharmacy service","hospital","pilot projects","polypharmacy","program evaluation","prospective studies","referral and consultation","renal insufficiency","chronic","self medication","severity of illness index","surveys and questionnaires","time factors"],"authorIDs":[],"dataSources":["yP2f7ZTqzqGzG39kW"]}