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Category: Volume 07 Issue 05 May 2019
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Title: A Descriptive Analysis of Prescribing Patterns of Drugs in Chronic Kidney Disease Patients on Maintenance Hemodialysis

Authors: Chandel Ritesh Kumar, Bhargava Jyotsna, Dadheech Jaya

 DOI: https://dx.doi.org/10.18535/jmscr/v7i5.126

Abstract

Introduction: Chronic kidney disease is a global threat to health particularly for developing countries because of its increasing incidence, poor outcome and high cost of treatment. The treatment includes dialysis and renal transplantation. Appropriate drug selection for patients with chronic kidney disease (CKD) is important in order to avoid unwanted drug effects and to ensure optimal patient outcomes. Rational drug prescription is a difficult task in CKD patients. So, present study was planned to know the prescribing pattern of drugs in chronic kidney disease on maintenance hemodialysis at Jaipur, Rajasthan.

Materials and Methods: The study was carried out in Department of Pharmacology in association with Department of Nephrology, S.M.S. Medical College & Hospital, Jaipur (Rajasthan) from April 2017 to March 2018. Socio-demographic profile and details of drugs administered were recorded in a predesigned and pretested proforma. Results were expressed as percentages and proportions. Pearson’s correlation coefficient (r) was calculated to show correlation between drug-drug interaction and drug per prescription.

Results: In the present study, out of160 chronic kidney patients majority were males (75.63%) with mean age of 39.5 ± 13.29 years and 24.37% were females with mean age of 40.41 ± 13.53 years. Co-morbidities were anemia (98.13%), hypertension (95.65%), infections (22.5%) and diabetes mellitus (6.85%). Mean number of drugs per prescription were 7.84 ± 1.40. Majority of prescriptions (86.87%) contained 6 to 9 drugs. Most common drugs prescribed were vitamins and minerals (32%) followed by cardiovascular drugs (21.03%) and hematopoietic drugs (14.58%). Majority of prescription (75.62%) contained 3-5 drug-drug interactions (DDIs) and the number of DDIs increased with increasing number of drugs per prescription (r = 0.2606, p value < 0.001).

Conclusion: Certain areas of concern such as polypharmacy, underuse of erythropoietin stimulating agents and calcium free phosphate binders and high incidence of potential DDIs were addressed in the present study. There is a need for exploring these issues in detail through future drug use studies.

Keywords: Chronic Kidney Disease, Maintenance Hemodialysis, Prescribing Patterns.

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Corresponding Author

Bhargava Jyotsna

Sr. Professor, Department of Pharmacology, SMS Medical College, Jaipur, Rajasthan, India