Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2013 Jul 13:14:96.
doi: 10.1186/1471-2296-14-96.

Effectiveness of a drug dosing service provided by community pharmacists in polymedicated elderly patients with renal impairment--a comparative study

M Angeles Via-Sosa  1 , Natali Lopes, Marian March
Affiliations
Comparative Study

Effectiveness of a drug dosing service provided by community pharmacists in polymedicated elderly patients with renal impairment--a comparative study

M Angeles Via-Sosa et al. BMC Fam Pract. .

Abstract

Background: Drug dosing errors are common in renal-impaired patients. Appropriate dosing adjustment and drug selection is important to ensure patients' safety and to avoid adverse drug effects and poor outcomes. There are few studies on this issue in community pharmacies. The aims of this study were, firstly, to determine the prevalence of dosing inadequacy as a consequence of renal impairment in patients over 65 taking 3 or more drug products who were being attended in community pharmacies and, secondly, to evaluate the effectiveness of the community pharmacist's intervention in improving dosing inadequacy in these patients when compared with usual care.

Methods: The study was carried out in 40 Spanish community pharmacies. The study had two phases: the first, with an observational, multicentre, cross sectional design, served to determine the dosing inadequacy, the drug-related problems per patient and to obtain the control group. The second phase, with a controlled study with historical control group, was the intervention phase. When dosing adjustments were needed, the pharmacists made recommendations to the physicians. A comparison was made between the control and the intervention group regarding the prevalence of drug dosing inadequacy and the mean number of drug-related problems per patient.

Results: The mean of the prevalence of drug dosing inadequacy was 17.5% [95% CI 14.6-21.5] in phase 1 and 15.5% [95% CI 14.5-16.6] in phase 2. The mean number of drug-related problems per patient was 0.7 [95% CI 0.5-0.8] in phase 1 and 0.50 [95% CI 0.4-0.6] in phase 2. The difference in the prevalence of dosing inadequacy between the control and intervention group before the pharmacists' intervention was 0.73% [95% CI (-6.0) - 7.5] and after the pharmacists' intervention it was 13.5% [95% CI 8.0 - 19.5] (p < 0.001) while the difference in the mean of drug-related problems per patient before the pharmacists' intervention was 0.05 [95% CI( -0.2) - 0.3] and following the intervention it was 0.5 [95% CI 0.3 - 0.7] (p < 0.001).

Conclusion: A drug dosing adjustment service for elderly patients with renal impairment in community pharmacies can increase the proportion of adequate drug dosing, and improve the drug-related problems per patient. Collaborative practice with physicians can improve these results.

PubMed Disclaimer

Figures

Figure 1
Figure 1
General schema of study.
Figure 2
Figure 2
Breakdown of percentage Anatomical Groups (ATC).
Figure 3
Figure 3
Type of recommendations made to GPs in the intervention group in phase 2.
See this image and copyright information in PMC

References

    1. Bayes B, Romero C. Cardiovascular disease and chronic renal failure or vice versa. Med Clin (Barc) 2008;131(2):60–62. - PubMed
    1. Fernandez-Vega F, Marin-Iranzo R. Función renal en el anciano:el pago del tiempo. Hipertensriesgo vasc. 2009;26(1):2–6.
    1. Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P. et al.Prevalence of chronic kidney disease in the United States. JAMA. 2007;298:2038–2047. - PubMed
    1. Otero A, de Francisco A, Gayoso P. et al.Prevalence of chronic renal disease in Spain: Resuts of the EPIRCE Study. Nefrologia. 2010;30(1):78–86. - PubMed
    1. Hahr AJ, Molitch ME. Diabetes, cardiovascular risk and nephropathy. CardiolClin. 2010;28:467–475. - PubMed