Abstract: TH-PO304
Reducing Polypharmacy in Dialysis Patients
Session Information
- Dialysis: Cost, Socioeconomics, Quality of Life
October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Jameson, Travis R., Loyola University Medical Center, MAYWOOD, Illinois, United States
- Schneider, Julia, Loyola University Medical Center, Maywood, Illinois, United States
- Kramer, Holly J., Loyola University Medical Center, Maywood, Illinois, United States
Background
Polypharmacy is a freqent problem for patients receiving maintenance dialysis and may increase risk of adverse events and drug interactions. Previous studies have identified 4 drug classes (proton pump inhibitors [PPI], alpha 1 blockers [A1B], diuretics, and statins) in which use may not be necessary in patients receiving maintenance dialysis. This study examined overall medication use and use of 4 non-essential drug classes.
Methods
This study was comprised of 168 patients receiving maintenance dialysis at a single dialysis unit. The mean age was 60.4 (SD 15.8) and median dialysis vintage was 2.4 years with a range of 0.2 to 13.9 years. Overall 49.1% were male. Diabetes mellitus (49.1%) and hypertention (18.0%) were the two main causes of end stage renal disease. The average number of prescribed medications was 11 (SD 5) and ranged from 2-26 medications but was higher among women (11[SD 4]) than among men (10[SD 5]).
Results
Of the 4 non-essential drugs, 51.5% were taking at least one of these drugs, 36.9% were taking at least 2, and 11.5% were taking at least three non-essential medications. Statin use was most common at 56.3% overall and among patients age 70+ years, 75% were using statins. PPI and diuretic use wee noted in 32.5% and 31.7% respectively. A1B use was noted in 8.5% of men with a dialysis vintage of 2.4 years. If the 4 non-essential drugs were eliminated, the average number of medications would decrease to 9 (SD 4) overall, to 9 (SD 5) among men and to 10 (SD 4) for women.
Conclusion
In conclusion, use of non-essential medications is common among patients receiving maintenance dialysis. Elimination of non-essential medications would lead to a reduction of about 1 medication on average. Targeted de-prescribing may help reduce polypharmacy in this patient population.