TY - JOUR
T1 - Inappropriate prescribing in patients with kidney disease
T2 - A rapid review of prevalence, associated clinical outcomes and impact of interventions
AU - Hamzaei, Zohra
AU - Houlind, Morten Baltzer
AU - Kjeldsen, Lene Juel
AU - Christensen, Louise Westberg Strejby
AU - Walls, Anne Byriel
AU - Aharaz, Anissa
AU - Olesen, Charlotte
AU - Coric, Faruk
AU - Revell, Joo Hanne Poulsen
AU - Ravn-Nielsen, Lene Vestergaard
AU - Andersen, Trine Rune Høgh
AU - Hedegaard, Ulla
N1 - © 2024 The Authors. Basic & Clinical Pharmacology & Toxicology published by John Wiley & Sons Ltd on behalf of Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).
PY - 2024/4
Y1 - 2024/4
N2 - BACKGROUND: The prevalence of patients with chronic kidney disease (CKD) and polypharmacy is increasing and has amplified the importance of examining inappropriate prescribing (IP) in CKD. This review focuses on the latest research regarding the prevalence of IP in CKD and the related adverse clinical effects and explores new interventions against IP.METHOD: A literature search was performed using PubMed, EMBASE and the Cochrane Library searching articles published between June 2016 and March 2022.RESULTS: Twenty-seven studies were included. An IP prevalence of 12.6% to 96% and 0.3% to 66% was reported in hospital and outpatient settings, respectively. In nonhospital settings, the prevalence of IP varied between 3.9% and 60%. IP was associated with higher risk of hospitalisation (HR 1.46, 95% CI 1.17-1.81), higher bleeding rate (HR 2.34, 95% CI 1.32 to 3.37) and higher risk of all-cause mortality (OR 1.07, 95% CI 1.02 to 1.13). Three studies reported the impact of interventions on IP.CONCLUSION: This review highlights widespread IP in CKD patients across healthcare settings, with varying prevalence rates. IP is substantially linked to adverse outcomes in patients. While limited interventions show promise, urgent research is needed to develop effective strategies addressing IP and improving CKD patient care.
AB - BACKGROUND: The prevalence of patients with chronic kidney disease (CKD) and polypharmacy is increasing and has amplified the importance of examining inappropriate prescribing (IP) in CKD. This review focuses on the latest research regarding the prevalence of IP in CKD and the related adverse clinical effects and explores new interventions against IP.METHOD: A literature search was performed using PubMed, EMBASE and the Cochrane Library searching articles published between June 2016 and March 2022.RESULTS: Twenty-seven studies were included. An IP prevalence of 12.6% to 96% and 0.3% to 66% was reported in hospital and outpatient settings, respectively. In nonhospital settings, the prevalence of IP varied between 3.9% and 60%. IP was associated with higher risk of hospitalisation (HR 1.46, 95% CI 1.17-1.81), higher bleeding rate (HR 2.34, 95% CI 1.32 to 3.37) and higher risk of all-cause mortality (OR 1.07, 95% CI 1.02 to 1.13). Three studies reported the impact of interventions on IP.CONCLUSION: This review highlights widespread IP in CKD patients across healthcare settings, with varying prevalence rates. IP is substantially linked to adverse outcomes in patients. While limited interventions show promise, urgent research is needed to develop effective strategies addressing IP and improving CKD patient care.
KW - Drug-Related Side Effects and Adverse Reactions/epidemiology
KW - Hospitalization/statistics & numerical data
KW - Humans
KW - Inappropriate Prescribing
KW - Polypharmacy
KW - Prevalence
KW - Renal Insufficiency, Chronic/epidemiology
KW - chronic kidney disease
KW - inappropriate prescribing
KW - renal insufficiency
KW - drug-related problems
KW - treatment outcome
UR - http://www.scopus.com/inward/record.url?scp=85185453008&partnerID=8YFLogxK
U2 - 10.1111/bcpt.13986
DO - 10.1111/bcpt.13986
M3 - Review
C2 - 38348501
SN - 1742-7843
VL - 134
SP - 439
EP - 459
JO - Basic & clinical pharmacology & toxicology
JF - Basic & clinical pharmacology & toxicology
IS - 4
ER -