Kidney Week

Abstract: TH-PO1075

Assessing Baseline Medication Use in CKD: An Analysis of the SHARP-ER Study

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - I
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Jun, Min, The George Institute for Global Health, UNSW Sydney, Newtown, New South Wales, Australia

Min Jun,

• Sukkar, Louisa, The George Institute for Global Health, Sydney, New South Wales, Australia

Louisa Sukkar,

• Jardine, Meg J., The George Institute for Global Health, UNSW, Newtown, New South Wales, Australia

Meg J. Jardine,

• Talbot, Ben, George Institute, Erskineville, New South Wales, Australia

Ben Talbot,

• Cass, Alan, Menzies School of Health Research, Darwin, Northern Territory, Australia

Alan Cass,

• Landray, Martin J., University of Oxford, Oxford, United Kingdom

Martin J. Landray,

• Reith, Christina A., CTSU, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom

Christina A. Reith,

• Walker, Robert J., University of Otago, Dunedin, New Zealand

Robert J. Walker,

• Gallagher, Martin P., The George Institute for Global Health, UNSW Sydney, Newtown, New South Wales, Australia

Martin P. Gallagher,

Group or Team Name

• SHARP-ER Study Collaborators

Background

Medication use of patients with CKD in Australia is accepted as high, but systematic, national data has not been available. The Pharmaceutical Benefits Scheme (PBS), a national program providing medication subsidies in Australia, offers a novel means of medication use pattern assessment in CKD based on routinely collected data. We assessed baseline medication use in CKD patients of the SHARP-ER study using PBS data.

Methods

Australian participants from the SHARP-ER study, a 5-year post-trial (2010-2015) extended follow-up of SHARP participants known to be alive at the end of the trial (study of cholesterol-lowering in CKD) in Australia, New Zealand and Malaysia, were linked to the PBS. Prescription medication dispensation in the year prior to SHARP-ER baseline, defined as the first study visit which occurred 1.5-2 years following the final SHARP visit, were obtained. We examined medication use (receipt of ≥1 prescription) from any of the following medication groups: cardioprotective (blood pressure-lowering, lipid-lowering, glucose-lowering, anticoagulant, antiplatelet, anaemia treatment), anti-infective, immunosuppressant, proton pump inhibitor (PPI) treatment and others.

Results

Of 304 participants, 86 (28.3%) were on maintenance dialysis at baseline. Overall, there were 11,272 unique prescriptions dispensed in the year prior to baseline which included those for cardioprotective (58.4%), anti-infective (9.6%), immunosuppressive (7.6%), PPI (12.6%) treatment and others (11.6%). On average, patients were prescribed 6 different medications (IQR:4-8). The distributions of medication use across the medication groups in the 304 participants were: 92.8%, 68.4%. 25.3%, 53.3% and 54.3%, respectively. The proportion of patients receiving ≥3 medication groups was significantly higher among those on dialysis (76.7% vs. 64.7%;p=0.04) compared with non-dialysis CKD patients.

Conclusion

PBS data in patients with moderate-to-severe CKD suggests a high medication burden primarily directed at cardiovascular risk mitigation. Further longitudinal assessments of cardioprotective and anti-infective medication use according to patient characteristics are needed.

Funding

• Government Support - Non-U.S.