ArticleJournal of general internal medicine2008
Overdose rate of drugs requiring renal dose adjustment: data analysis of 4 years prescriptions at a tertiary teaching hospital.
Article in Journal of general internal medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Drug-Related Problems in Hospitalised Patients with Chronic Kidney Disease: A Systematic Review.Drug safety · 2021Pooled it
- Computerized clinical decision support during medication ordering for long-term care residents with renal insufficiency.Journal of the American Medical Informatics Association : JAMIATrial
- Assessment of Drug Dosing Appropriateness in Hospitalized Chronic Kidney Disease Patients with Cardiovascular Diseases: A Cross-Sectional Study in the Al-Baha Region, Saudi Arabia (2023-2025).Journal of clinical medicine · 2026Article
- Drug-related problems in hospitalized patients with chronic kidney diseases and clinical pharmacist interventions.BMC geriatrics · 2023Article
- Review
- Incorporating Uremic Solute-mediated Inhibition of OAT1/3 Improves PBPK Prediction of Tenofovir Renal and Systemic Disposition in Patients with Severe Kidney Disease.Pharmaceutical research · 2023Article
- Pattern, frequency and factors associated with inappropriate high dosing in chronic kidney disease patients at a tertiary care hospital in Pakistan.BMC nephrology · 2023Article
- Prevalence of inappropriate drug dose adjustment and associated factors among inpatients with renal impairment in Africa: A systematic review and meta-analysis.SAGE open medicine · 2023Review
- In-Hospital Prescription Checking System for Hospitalized Patients with Decreased Glomerular Filtration Rate.Kidney360 · 2022Article
- Evaluation of Pharmacist Renal Dose Adjustments and Planning for Future Evaluations of Pharmacist Services.Hospital pharmacy · 2021Article
- Kidney Function, Polypharmacy, and Potentially Inappropriate Medication Use in a Community-Based Cohort of Older Adults.Drugs & aging · 2018Article
- Using the diffusion of innovations theory to assess socio-technical factors in planning the implementation of an electronic health record alert across multiple primary care clinics.Journal of innovation in health informatics · 2016Article
- Use of Renally Inappropriate Medications in Older Veterans: A National Study.Journal of the American Geriatrics Society · 2015Article
- Adherence with Dosing Guideline in Patients with Impaired Renal Function at Hospital Discharge.PloS one · 2015Article
- Adverse drug events during AKI and its recovery.Clinical journal of the American Society of Nephrology : CJASN · 2013Observational
- A quantitative method for assessment of prescribing patterns using electronic health records.PloS one · 2013Article
- Inappropriate drug use and mortality in community-dwelling elderly with impaired kidney function--the Three-City population-based study.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2011Article
- Analysis of Relationship between Levofloxacin and Corrected QT Prolongation Using a Clinical Data Warehouse.Healthcare informatics research · 2011Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the overdose rate of drugs that require renal dose adjustment and factors related with overdose. SUBJECTS: Total of 23,635,210 records of prescriptions and laboratory data of inpatients at a tertiary teaching hospital for the period from January 2002 to December 2005.
methodsA clinical data mart was constructed. A knowledge base containing dose adjusting information about 56 drugs was built. One day dose was compared to the reference dose adjusted to the patient's renal function.
resultsConsidering the patient's renal function, 5.3% of drug doses were excessive. The overdose rate in the patients with moderate to severe renal insufficiency was 28.2%. Only 25% of physicians were responsible for 50.6% of the overdoses. Of 56 drugs studied, 10 drugs, including ranitidine, amoxicillin, and piperacillin/tazobactam, were involved in 85.4% of the overdoses. The physicians with high overdose rate had patients with more impaired renal function (correlation coefficient = 0.192, P < .001). There were negative correlation between clinical experiences of physician and overdose rate (correlation coefficient = -0.221, P < .001) and workload of prescription (correlation coefficient = -0.446, P < .001), when excluding interns from the analyses. There was positive correlation between workload of prescription and overdose rate (correlation coefficient = 0.361, P < .001).
conclusionA clinical data mart was useful to analyze the vast amount of electronic hospital data. Drug overdose is quite common among inpatients with renal insufficiency. Only a few drugs are responsible for most of drug overdoses. The physicians' clinical experience, workload of prescriptions, and patients' renal function are correlated with drug overdose.
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