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Kidney Week

Abstract: PO2394

Identification of Common Medication Therapy Problems in a High-Risk CKD Population

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Weltman, Melanie R., University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania, United States
  • Cai, Manqi, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, United States
  • Yabes, Jonathan, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, United States
  • Abdel-Kader, Khaled, Vanderbilt University Division of Nephrology and Hypertension, Nashville, Tennessee, United States
  • Jhamb, Manisha, University of Pittsburgh Renal-Electrolyte Division, Pittsburgh, Pennsylvania, United States
  • Nolin, Thomas D., University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania, United States
Background

Medication therapy problems (MTPs) are commonly experienced by patients with chronic kidney disease (CKD) and have the potential to increase morbidity, mortality, and healthcare costs. As part of the Kidney Coordinated Health Management Partnership (Kidney CHAMP), an NIH funded, pragmatic randomized controlled trial testing an electronic health record- (EHR) based population health management approach to improve CKD care, we characterize the types and prevalence of MTPs in a population of high-risk CKD patients.

Methods

Eligible patients are 18 to 85 years old with CKD who have a high risk of progression to ESKD and are not being followed by a nephrologist. MTPs are identified through pharmacist-led telephonic medication therapy management (MTM) and electronic consult by nephrology specialists. Recommendations for resolution of MTPs are provided in the EHR to the primary care provider for review at the upcoming office visit.

Results

To date, in 493 intervention patients, 724 MTPs have been identified. Most patients (76%) experienced at least one MTP. The most common MTP identified was ‘needs additional medication therapy,’ followed by ‘suboptimal medication,’ and ‘dosage too high.’ New indications for SGLT2 inhibitors contributed largely to the ‘needs additional medication therapy’ category. The most common suboptimal medications identified were NSAIDs, with 15% of patients reporting over the counter or prescription use.

Conclusion

Patients with high-risk CKD experience a sizeable burden of MTPs. Identification of existing MTPs in the community setting is an important first step in the optimization of a medication regimen, with the succeeding goal to resolve and prevent MTPs and improve CKD care and outcomes.

MTP categoryn% with regard to MTPs
(N=724)
Needs additional med therapy21429.6%
Suboptimal medication13819.1%
Dosage too high10514.5%
Dosage too low8211.3%
Drug interaction537.3%
Needs additional monitoring476.5%
Unnecessary med therapy446.1%
Adverse med event253.5%
Failure to receive drug162.2%

Funding

  • NIDDK Support