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Kidney Week

Abstract: SA-PO616

Medication Reconciliation in Veterans Receiving Dialysis at Edward Hines VA Hospital: A Quality Improvement Initiative

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Cintrón-García, Juan J., Loyola University Health System, Maywood, Illinois, United States
  • Guerrero, Roberto, Loyola University Health System, Maywood, Illinois, United States
  • Kramer, Holly J., Loyola University Health System, Maywood, Illinois, United States
  • Griffin, Karen A., Loyola University Health System, Maywood, Illinois, United States
  • Vellanki, Kavitha, Loyola University Health System, Maywood, Illinois, United States
Background

Polypharmacy, commonly defined as use of 5 or more medications, is associated with higher morbidity, fall risk, functional decline and disability. We aimed to identify prevalence of medication discrepancy and possible risk factors in veterans receiving dialysis at Hines VA hospital.

Methods

Eligible patients were asked to bring all pill bottles at least once during the study period, October 2022 to March 2023. Medical records were then reviewed to identify discrepancies. Collected data included age, race, sex, cause of end stage renal disease (ESRD), dialysis vintage time, dialysis modality, no: of providers involved, no: of prescribed medications and presence of care giver at home. Cognitive screening was done using Montreal Cognitive Assessment Test (MoCA).

Results

A total 48 patients participated in the study. Baseline characteristics are shown in Table 1. 32 patients had at least one medication discrepancy. Compared to patients that completed MoCA (36/48), those that declined (12/48) had higher percentage of medication discrepancies (75% vs. 63%) despite having a caregiver (71% vs. 61%) (Image 1). 11 of the 12 patients declining MoCA were receiving hemodialysis (HD).

Conclusion

We found high prevalence of medication discrepancy in our veteran ESRD patients. MoCA scores were not associated with medication discrepancies, but those declining MoCA or with poor overall interest tended to have more discrepancies. Our study limitation is small sample size of a single center veteran population.

Baseline characteristics of study population
Age in yearsAverage age: 68
Race29-African American 17-White 2-Other race
Sex46-Male 2-Female
Cause of ESRD29-DM 6-HTN 3-GN 10-Other
Dialysis vintage time in yearsAverage 3.7 years
Modality of dialysis (HD vs. PD)41-HD 7-PD
No: of providers involved in careAverage: 3
No: of prescribed medicationsAverage: 9
Mean MoCA score (N = 36)20 (total score = 30)

Image 1

Funding

  • Veterans Affairs Support