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Abstract: FR-PO053

Handout on Over-the-Counter Medication Safety in CKD Improves Internal Medicine Resident Confidence and Knowledge

Session Information

  • Educational Research
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Educational Research

  • 1000 Educational Research


  • Annadanam, Surekha Uma, University of Michigan, Ann Arbor, Michigan, United States
  • Heung, Michael, University of Michigan, Ann Arbor, Michigan, United States
  • Sukul, Nidhi, University of Michigan, Ann Arbor, Michigan, United States
  • Perlman, Rachel Leah, University of Michigan, Ann Arbor, Michigan, United States
  • Wright Nunes, Julie A., University of Michigan, Ann Arbor, Michigan, United States

Drug-related nephrotoxicity can lead to acute kidney injury, chronic kidney disease (CKD) progression, or even end stage kidney disease. There are limited electronic medical record (EMR)-based educational materials with information on over-the-counter (OTC) medication safety for patients with CKD. The goal of our study was to introduce an EMR-based educational handout to internal medicine resident physicians and evaluate whether their knowledge and confidence in OTC medication safety counseling for CKD changed following.


Internal medicine and internal medicine-pediatric (med-peds) residents at the University of Michigan were recruited to participate in the introduction and training for the EMR-based handout. The handout was previously developed by experts in nephrology for use during patient-provider encounters. Pre-tests and post-tests were administered prior to and immediately after review of the handout. Resident confidence was gauged using survey questions with item responses consisting of a 7-point Likert scale. Differences in proportions were assessed using chi-squared tests. This project was IRB approved.


35 residents completed training for the EMR-based handout: mean (SD) age was 28.3 years (1.8) and 46% were female. Ninety-four percent were general internal medicine and 6% were med-peds residents. Comparing pre-test and post-test scores, a higher proportion of residents correctly identified medication safety profiles for patients with CKD following training: low dose aspirin (pre-test = 57.1% vs post-test = 94.3%, p < 0.01), antihistamines (71.4% vs 97.1%, p < 0.01), guaifenesin (74.3% vs 97.1%, p = 0.01), dextromethorphan (40.0% vs 88.6%, p < 0.01), and Pepto-Bismol (68.6% vs 91.4%, p = 0.03). A higher proportion noted concerns with pseudoephedrine (68.6% vs 94.3%, p = 0.03) and Kaopectate (42.9% vs 100.0%, p < 0.01) for routine use in patients with CKD. Following training, residents felt more confident in their knowledge (4.2 vs 6.3, p < 0.01) and in counseling patients with CKD on OTC medication safety (4.0 vs 6.2, p < 0.01).


One-time didactic training using an EMR-based handout about OTC medication safety enhanced resident knowledge and confidence in counseling patients with CKD.