Evidence map›Paper›PMID 28416321›Full record

ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2017

Targeted Deprescribing in an Outpatient Hemodialysis Unit: A Quality Improvement Study to Decrease Polypharmacy.

Caitlin McIntyre, Rory McQuillan, Chaim Bell, Marisa Battistella

2 registry-linked trialsAbstract read
PubMed Publisher
In one paragraph

Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 41 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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.

NCT03663049 phase4unknown statusstarted 2018, after this paper: background citation

Trial of Statin Holiday in Patients Receiving Maintenance Dialysis

Ran2018Enrolled30Registered outcomes5Posted comparisons0ConditionsCardiovascular Diseases, ESRDArmsdiscontinue statin
PMID 23975627PMID 19332456PMID 21663949PMID 28464924PMID 8747848PMID 9214400PMID 26255306PMID 12552501PMID 16978493PMID 17942958PMID 20576825PMID 21566054other papers from this trial
Open the trial in the graph
NCT05585268 nacompletednot on this mapstarted 2022, after this paper: background citation

Electronic Decision Support for Deprescribing in Patients on Hemodialysis: a Prospective, Controlled, Quality Improvement Study

TypeinterventionalSponsorMcGill University Health Centre/Research Institute of the McGill University Health CentreRan2022 to 2022Enrolled195ConditionsEnd Stage Renal Disease, Hypertension, Diabete Type 2, Renal Failure ChronicArmsMedication reconciliation supplemented with MedSafer and deprescribing brochures
3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Effect of pharmacist interventions in chronic kidney disease: a meta-analysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025
    Pooled it
  3. Pooled it
  4. Ten tips for the first hemodialysis sessions.Clinical kidney journal · 2026
    Review
  5. Article
  6. Article
  7. Chronic kidney disease.Nature reviews. Disease primers · 2025
    Review
  8. Article
  9. Article
  10. Review
  11. Review
  12. Article
  13. [Polypharmacy in acute and chronic kidney diseases].Innere Medizin (Heidelberg, Germany) · 2024
    Review
  14. Article
  15. Review
  16. Review
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Caitlin McIntyreDepartment of Pharmacy, University Health Network, Toronto, Ontario, Canada; Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Rory McQuillanDivision of Nephrology, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Chaim BellDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Marisa BattistellaDepartment of Pharmacy, University Health Network, Toronto, Ontario, Canada; Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada. Electronic address: marisa.battistella@uhn.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPolypharmacy in hemodialysis patients can result in adverse patient outcomes. Deprescribing tools can reduce polypharmacy, yet no method exists for an outpatient hemodialysis population.

designQuality improvement study. SETTING &

participants240 patients in a tertiary-care outpatient hemodialysis unit. QUALITY IMPROVEMENT PLAN: We aimed to: (1) develop a deprescribing tool for target medications with poor evidence for efficacy and safety, (2) determine its effectiveness in decreasing polypharmacy, and (3) monitor patient safety and satisfaction. OUTCOMES: The primary outcome was the proportion of target medications completely deprescribed after 4 weeks. Secondary outcomes were the proportion of target medications completely deprescribed after 6 months, average number of medications per patient before and after deprescription, and proportion of successful deprescriptions for each target medication. MEASUREMENTS: Number of medications deprescribed at 4 weeks and 6 months. Patient safety and satisfaction were monitored using drug-specific monitoring parameters.

resultsA deprescribing tool for specific medications was developed and implemented in the hemodialysis unit. 5 medication classes were selected: quinine, diuretics, α LIMITATIONS: Single-center study that relied on patient self-reporting of medication use and adherence to our recommendations.

conclusionsDeprescribing tools can be applied successfully in an outpatient hemodialysis unit to reduce polypharmacy while maintaining patient safety and satisfaction.

Indexed as

DeprescriptionsPolypharmacyQuality ImprovementAdrenergic alpha-AntagonistsAdultAgedAged, 80 and overAmbulatory CareDiureticsFemaleHemodialysis Units, HospitalHumansHydroxymethylglutaryl-CoA Reductase InhibitorsKidney Failure, ChronicMaleMiddle AgedAdrenergic alpha-AntagonistsDiureticsHydroxymethylglutaryl-CoA Reductase InhibitorsMuscle Relaxants, CentralProton Pump InhibitorsQuinineDeprescribingelderlyend-stage renal disease (ESRD)hemodialysis (HD)medication optimizationmedication prescribing patternsoutpatient HDpatient safetypill burdenpolypharmacypotentially inappropriate medicationsquality improvement activity

Identifiers

PMID28416321

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.