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Abstract: PO2397

Prevalence of Polypharmacy and Associated Adverse Health Outcomes in Patients with CKD: A Systematic Review and Meta-Analysis

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Tinwala, Mohammed M., University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  • Zaidi, Deenaz, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  • Ye, Feng, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  • Muneer, Shezel, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  • Ghimire, Anukul, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  • Khan, Maryam, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  • Sultana, Naima, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  • Okpechi, Ikechi G., University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  • Ronksley, Paul E., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  • Drummond, Neil, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  • Mangin, Dee, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
  • Bello, Aminu K., University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
Background

Patients with chronic kidney disease (CKD) are at increased risk of adverse health outcomes associated with excessive medication use (polypharmacy) due to impaired kidney function and multimorbidity. However, data on the associations of polypharmacy and adverse health outcomes in this population are limited. We conducted a systematic review and meta-analysis to determine the prevalence of polypharmacy and its associated health consequences in CKD.

Methods

The study was conducted using a pre-specified study protocol and adheres to PRISMA reporting guidelines. Six electronic databases were searched from inception to September 2020 for studies that included patients with CKD, use of polypharmacy, and associated adverse health outcomes. Random effects models were used to pool the prevalence of polypharmacy and associations with health outcomes.

Results

53 eligible articles (n = 477,909 patients) met criteria for inclusion. The pooled prevalence of polypharmacy and excessive polypharmacy was 76.2% (95% CI 73.2%-79.1%; range 14.9% to 100%) and 37.4% (95% CI 30.0%-45.2%; range 11.4% to 63.0%), respectively (Figure 1). The prevalence of polypharmacy was 72.7% and 87.1% in non-dialysis CKD and dialysis populations, respectively. 17 studies reported significant associations between polypharmacy and adverse health outcomes. These studies found an increased risk for potentially inappropriate medication use, drug-drug interactions, drug-related problems, medication-related problems, adverse drug reactions, decreased quality of life, decreased kidney function, hospitalization, and mortality.

Conclusion

Polypharmacy is common in CKD and linked to adverse health outcomes. Our findings highlight the need for improved prescribing practices in CKD and the development of strategies to reduce polypharmacy.

Funding

  • Government Support – Non-U.S.