Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy

A Jeong Kim, Hayeon Lee, Eun-Jeong Shin, Eun-Jung Cho, Yoon Sook Cho, Hajeong Lee and Ju-Yeun Lee
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A Jeong Kim: Department of Pharmacy, Seoul National University Hospital, Seoul 03080, Korea
Hayeon Lee: Department of Pharmacy, Seoul National University Hospital, Seoul 03080, Korea
Eun-Jeong Shin: Department of Pharmacy, Seoul National University Hospital, Seoul 03080, Korea
Eun-Jung Cho: Department of Pharmacy, Seoul National University Hospital, Seoul 03080, Korea
Yoon Sook Cho: Department of Pharmacy, Seoul National University Hospital, Seoul 03080, Korea
Hajeong Lee: Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Korea
Ju-Yeun Lee: College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Korea

IJERPH, 2021, vol. 18, issue 8, 1-8

Abstract: Inappropriate polypharmacy is likely in older adults with chronic kidney disease (CKD) owing to the considerable burden of comorbidities. We aimed to describe the impact of pharmacist-led geriatric medication management service (MMS) on the quality of medication use. This retrospective descriptive study included 95 patients who received geriatric MMS in an ambulatory care clinic in a single tertiary-care teaching hospital from May 2019 to December 2019. The average age of the patients was 74.9 ± 7.3 years; 40% of them had CKD Stage 4 or 5. Medication use quality was assessed in 87 patients. After providing MMS, the total number of medications and potentially inappropriate medications (PIMs) decreased from 13.5 ± 4.3 to 10.9 ± 3.8 and 1.6 ± 1.4 to 1.0 ± 1.2 (both p < 0.001), respectively. Furthermore, the number of patients who received three or more central nervous system-active drugs and strong anticholinergic drugs decreased. Among the 354 drug-related problems identified, “missing patient documentation” was the most common, followed by “adverse effect” and “drug not indicated.” The most frequent intervention was “therapy stopped”. In conclusion, polypharmacy and PIMs were prevalent in older adults with CKD; pharmacist-led geriatric MMS improved the quality of medication use in this population.

Keywords: geriatric; potentially inappropriate medications; polypharmacy; medication management service; chronic kidney disease (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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