Kidney Week

Abstract: TH-PO0815

Quality Improvement Intervention to Reduce Medication Discrepancies in a CKD Population

Session Information

• Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)

• 1900 Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)

Authors

• Safi, Adnan, SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Adnan Safi, MBBS

• Kouyate, Gnama, SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Gnama Kouyate, MD

• Syed, Jahanghir, SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Jahanghir Syed, MD

• Akatibo, Emmanuel, SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Emmanuel Akatibo, MBChB

• Nenwani, Hari Vishal, SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Hari Vishal Nenwani, MBBS

• Suraj, Fnu, SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Fnu Suraj, MBBS

• Delp, Crystal, SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Crystal Delp, MD, MBBS

• Gruessner, Angelika C., SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Angelika C. Gruessner, PhD

• Salifu, Moro O., SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Moro O. Salifu, MD, MBA, MPH

• Saggi, Subodh J., SUNY Downstate Health Sciences University College of Medicine, New York, New York, United States

Subodh J. Saggi, MD, MPH

Background

Medication discrepancies are common in chronic kidney disease (CKD) because of polypharmacy, frequent regimen changes, and fragmented prescribing across multiple clinicians. These discrepancies may compromise patient safety, particularly for CKD-critical medications.

Methods

We conducted a pre-post quality improvement study evaluating a standardized medication reconciliation workflow in adults with CKD. Two cohorts were assessed: 40 patients pre-intervention and 40 post-intervention. The intervention included obtaining a best possible medication history through patient interviews and record review, comparing it with the EMR, identifying unintended discrepancies, and correcting or communicating these discrepancies to the clinical team. The emphasis was on CKD-critical medications, such as ACEIs/ARBs and SGLT2 inhibitors. Primary outcomes included the proportion of patients with at least one discrepancy and total discrepancy burden, while secondary outcomes assessed ACEI/ARB-related discrepancies and medications prescribed by outside physicians.

Results

We conducted a pre-post quality improvement study evaluating a standardized tool. Eighty patients were included. Patients with at least one medication discrepancy decreased from 90.0% pre-intervention to 37.5% post-intervention, an absolute reduction of 52.5 percentage points. Total discrepancies decreased from 277 to 35, representing an 87.4% relative reduction, while mean discrepancies per patient declined from 6.92 to 0.88. ACEI/ARB-related discrepancies fell from 35.0% to 0%. In the post-intervention cohort, 37.5% of patients were taking at least one medication prescribed by an outside physician, highlighting fragmented prescribing as a major contributor to medication-list inaccuracies.

Conclusion

A structured medication reconciliation workflow in CKD patients improved medication-list accuracy, reduced discrepancies, and eliminated ACEI/ARB-related errors. Frequent outside prescriptions emphasize the necessity of identifying external medications during reconciliation.