Abstract: FR-PO959

Awareness and Knowledge among Internal Medicine House-Staff for Dose Adjustment of Diabetes Medications in CKD

Session Information

  • Patient Safety
    November 03, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Patient Safety

  • 1501 Patient Safety

Authors

  • Snyder, Matthew S, Nassau University Medical Center, East Meadow, New York, United States
  • Fogel, Joshua, Brooklyn College, Brooklyn, New York, United States
  • Rubinstein, Sofia, Nassau University Medical Center, East Meadow, New York, United States
Background

Drug dosing errors result in adverse patient outcomes and are more common in patients with diabetes mellitus (DM) and chronic kidney disease (CKD). As internists treat the majority of patients with DM and CKD, we study if Internal Medicine house-staff (IMHS) have awareness and knowledge about the correct dosage of commonly used diabetes medications in those with CKD.

Methods

We surveyed 353 IMHS to evaluate incorrect awareness of whether a medication needs dose adjustment in patients with CKD (IR) and incorrect knowledge at what level of glomerular filtration rate a medication needs to be adjusted (IR-GFR) for Glipizide (GLI), Pioglitazone (PIO), and Sitagliptin (SIT).

Results

There were high percentages for lack of awareness and knowledge, with the highest for PIO at 72.8% (Figure). Multivariate logistic regression analyses showed that PGY1 had higher odds than PGY3 for GLI and SIT for both IR and IR-GFR and PGY2 had higher odds than PGY3 for PIO for both IR and IR-GFR. More Nephrology training and exposure in medical school or residency were each associated with lower odds for both IR and IR-GFR.

Conclusion

There is poor awareness and knowledge among IMHS for dose adjustment of diabetes medications in patients with DM and CKD. IMHS should receive more nephrology exposure and formal didactic educational training during medical school and residency to better manage complex treatment regimens and prevent medication dosing errors in those with DM and CKD.

Percentages for Incorrect Response to Medication Dose Needs Adjustment and Incorrect Response to Medication Dose Needs Adjustment at Appropriate GFR Level for Diabetic Medications