Evidence map›Paper›PMID 26280885›Full record

ArticleInternational journal of clinical pharmacy2015

Use of renal risk drugs in patients with renal impairment.

Hilde Holm, Kirsti Bjerke, Lone Holst, Liv Mathiesen

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Article in International journal of clinical pharmacy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
0.5field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.

  1. Pooled it
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  15. Observational
  16. The use of nephrotoxic drugs in patients with chronic kidney disease.International journal of clinical pharmacy · 2019
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Hilde HolmGjøvik Hospital Pharmacy, Hospital Pharmacies Enterprise, South Eastern Norway, Kyrre Greppsgt 11, 2819, Gjøvik, Norway. hilde.holm@sykehusapotekene.no.
Kirsti BjerkeDepartment of Global Public Health and Primary Care, Centre for Pharmacy, University of Bergen, Postboks 7804, 5020, Bergen, Norway.
Lone HolstDepartment of Global Public Health and Primary Care, Centre for Pharmacy, University of Bergen, Postboks 7804, 5020, Bergen, Norway.
Liv MathiesenHospital Pharmacies Enterprise, South Eastern Norway, Stenersgate 1, Postkasse 79, 0050, Oslo, Norway.
University of Bergen · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRenal impairment often goes unrecognised until the most advanced stages. Patients with renal impairment use a variety of drugs and the pharmacokinetics and drug effects are prone to change.

objectiveDescribe drug related problems in a population of patients with renal impairment, investigate possible risk factors, and investigate whether the clinical pharmacist can propose relevant measures to solve the problems.

settingThe internal medicine department at Innlandet Hospital Trust Gjøvik, Norway.

methodA prospective study enrolling patients (≥18 years) with moderate and severe renal impairment, i.e. with glomerular filtration rate of 30-59 and 15-29 ml/min/1.73 m(2), respectively, and using at least one drug. The clinical pharmacist reviewed the patients' drug regimen with focus on drug related problems, related to renal function. Problems identified were discussed with the multidisciplinary team, or directly with the physician.

main outcome measureThe number of drug related problems.

resultsThe results are based on data from 79 patients, 21 with severe and 58 with moderate renal impairment. Most patients, 92.4 %, used 5 or more drugs; in average 10.2 (range 2-27). In total, 88 drug related problems were identified in 49 patients, i.e. in 62 %. The most frequently occurring problems were incorrect dose (45.5 %) and inappropriate drug (41.0 %). There was a significant correlation between both the degree of renal impairment and the number of drugs, and the number of drug related problems. The acceptance rate of the clinical pharmacist's interventions was 95.7 %. The drugs most frequently associated with drug related problems were metformin, benzylpenicillin and furosemide.

conclusionDrug related problems often occur in patients with renal impairment. Incorrect drug dose and inappropriate drug choice according to the patients' renal function were the most common problems. Patients with the most complex drug treatment, i.e. with increasing degree of renal impairment and increasing number of drugs, are at greater risk of drug related problems. The high acceptance rate for the pharmacist's interventions supports the inclusion of a clinical pharmacist in the multidisciplinary treatment team to increase awareness and optimisation of the drug treatment in this patient group.

Indexed as

AgedAged, 80 and overDose-Response Relationship, DrugFemaleGlomerular Filtration RateHumansInappropriate PrescribingMaleNorwayPharmacistsPrescription DrugsProspective StudiesRenal InsufficiencyRisk FactorsSeverity of Illness IndexPrescription DrugsDrug-related problemMedication reviewNorwayPharmacist interventionRenal impairment

Identifiers

PMID26280885
OpenAlexW1918697728

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.