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Kidney Week

Abstract: PO1373

Dose Adjustment of Rheumatologic and Allergic Medications in CKD: Awareness and Knowledge Among Internal Medicine House Staff

Session Information

Category: Educational Research

  • 800 Educational Research

Authors

  • Loiodice, Jessica Maria, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, New York, United States
  • Fogel, Joshua, Brooklyn College Department of Business Managment, Brooklyn, New York, United States
  • Rubinstein, Sofia, Nassau University Medical Center, East Meadow, New York, United States
Background

Patients with chronic kidney disease (CKD) are at increased risk for adverse drug events due to medication dosing errors. We study the awareness and knowledge among Internal Medicine house-staff (IMHS) of proper dose adjustment of commonly used rheumatology and allergy/immunology medications for patients with CKD.

Methods

We surveyed 353 IMHS to evaluate their awareness of medication dose needs adjustment for patients with CKD and knowledge for medication adjustment by level of glomerular filtration rate for common rheumatology and allergy/immunology medications.

Results

There was lack of awareness and knowledge for both rheumatology and allergy/immunology medications. Not correct awareness and knowledge were: allopurinol (21.2%, 73.4%), colchicine (19.0%, 75.9%), diphenhydramine (34.0%, 34.0%), loratadine (82.2%, 93.2%), and montelukast (34.0%, 34.0%). Exploratory logistic regression analyses showed PGY1 residents had higher odds for lack of awareness for allopurinol (OR:24.57, 95% CI:4.69, 99.13, p<0.001), colchicine (OR:3.98, 95% CI:1.50, 10.51, p<0.01), diphenhydramine (OR:2.24, 95% CI:1.10, 4.54, p<0.04), and montelukast (OR:2.45, 95%CI:1.20, 5.00, p<0.05) than PGY3 residents. Nephrology rotation in medical school was associated with lower odds for incorrect knowledge for allopurinol (OR:0.46, 95%CI:0.25, 0.87, p<0.05) and montelukast (OR:0.50, 95%CI:0.27, 0.92, p<0.05).

Conclusion

Overall, awareness and knowledge was poor among IMHS for dose adjustments of rheumatology and allergy/immunology medications in patients with CKD. Proper education and exposure to nephrology during training may improve quality and safety of care for patients with CKD.