6533b860fe1ef96bd12c2ff2
RESEARCH PRODUCT
Kidney Disease Management in the Hospital Setting: A Focus on Inappropriate Drug Prescriptions in Older Patients
Vincenzo Arcoraci Maria Antonietta BarbieriRottura MichelangeloNobili AlessandroNatoli GiuseppeArgano ChristianoSquadrito GiovanniSquadrito FrancescoCorrao SalvatorePrisco DomenicoSilvestri ElenaEmmi GiacomoBettiol AlessandraMattioli IreneBiolo GianniZanetti MichelaBartelloni GiacomoVanoli MassimoGrignani Giulia Edoardo Alessandro PulixiLupattelli GrazianaBianconi VanessaAlcidi RiccardoGirelli DomenicoBusti FabianaMarchi GiacomoBarbagallo MarioDominguez LigiaBeneduce VincenzaCacioppo FedericaRaspanti MassimoZoli Marco Maria Laura MatacenaOrio GiuseppeMagnolfi EleonoraSerafini GiovanniSimili AngeloPalasciano Giuseppe Maria Ester Modeo Carla Di Gennaro Maria Domenica CappelliniFabio Giovanna Margherita Migone De Amicis Giacomo De LucaScaramellini NataliaCesari Matteo Paolo Dionigi RossiDamanti SarahClerici MartaLeoni Simona Alessandra Danuta Di Mauro Antonio Di SabatinoMiceli Emanuela Marco Vincenzo LentiPisati Martina Costanza Caccia DominioniPontremoli RobertoBeccati ValentinaNobili GiuliaLeoncini GiovannaAnastasio LuigiCarbone MariaCipollone Francesco Maria Teresa GuagnanoRossi IlariaMancuso GerardoCalipari DanielaBartone MosèDelitala GiuseppeBerria MariaDelitala AlessandroMuscaritoli MaurizioMolfino AlessioPetrillo EnricoGiorgi AntonellaGracin ChristianZuccalà GiuseppeD’aurizio GabriellaRomanelli GiuseppeMarengoni AlessandraVolpini AndreaLucente DanielaPicardi Antonio Umberto Vespasiani GentilucciGallo PaoloBellelli GiuseppeCorsi MaurizioAntonucci CesareSidoli ChiaraPrincipato GiuliaArturi FrancoSuccurro ElenaTassone BrunoGiofrè Federica Maria Grazia Serra Maria Antonietta BleveBrucato Antonio Teresa De FalcoFabris FabrizioBertozzi IreneBogoni Giulia Maria Victoria RabuiniPrandini TancrediRoberto ManfrediniFabio FabbianBoari BenedettaAlfredo De GiorgiTiseo RuanaPaolisso Giuseppe Maria Rosaria RizzoCatalano ClaudiaBorghi ClaudioStrocchi EnricoIanniello EugeniaSoldati MarioSchiavone SilviaBragagni AlessioSabbà Carlo Francesco Saverio VellaSuppressa Patrizia Giovanni Michele De VincenzoComitangelo AlessioAmoruso EmanueleCustodero CarloFenoglio LuigiFalcetta AndreaAnna L. FracanzaniTiraboschi SilviaCespiati AnnalisaOberti GiovannaSigon GiordanoPeyvandi FloraRossio RaffaellaColombo GiuliaAgosti PasqualeMonzani ValterSavojardo ValeriaCeriani GiulianaSalerno FrancescoPallini GiadaMontecucco FabrizioOttonello LucianoCaserza LaraVischi Giulia Nicola Lucio LiberatoTognin TizianaPurrello Francesco Antonino Di PinoPiro SalvatoreRozzini RenzoFalanga Lina Maria Stella Pisciotta Francesco Baffa BellucciBuffelli StefanoMontrucchio GiuseppePeasso PaoloFavale EdoardoPoletto CesareMargaria CarlSanino MauraVioli FrancescoPerri LudovicaGuasti LuiginaCastiglioni LuanaMaresca AndreaSquizzato AlessandroCampiotti LeonardoGrossi Alessandra Roberto Davide DiprizioBertolotti MarcoMussi ChiaraLancellotti Giulia Maria Vittoria LibbraGalassi MatteoGrassi YasmineGreco AlessioSciacqua AngelaPerticone MariaBattaglia RosaMaio RaffaeleStanghellini VincenzoRuggeri Eugenio Sara Del VecchioSalvi AndreaLeonardi RobertoDamiani GiampaoloCapeci WilliamMattioli Massimo Giuseppe Pio MartinoBiondi LorenzoPettinari PietroGhio Riccardo Anna Dal ColMinisola SalvatoreColangelo LucianoCilli MirellaLabbadia GiancarloAfeltra AntonellaMarigliano Benedetta Maria Elena PipitaCastellino PietroZanoli LucaGennaro AlfioGaudio AgostinoSaracco ValterFogliati MarisaBussolino CarloMete FrancescaGino MiriamVigorito CarloCittadini AntonioMoreo GuidoProlo SilviaPina GloriaBallestrero AlbertoFerrando FabioGonella RobertaCerminara DomenicoBerra SergioDassi Simonetta Maria Cristina NavaGraziella BrunoBaldassarre StefanoFragapani SalvatoreGruden GabriellaGalanti GiorgioMascherini GabrielePetri CristianStefani LauraGirino MargheritaPiccinelli ValeriaNasso FrancescoGioffrè VincenzaPasquale MariaSechi LeonardoCatena CristianaColussi GianlucaCavarape Alessandro Andea Da PortoPassariello NicolaRinaldi LucaBerti FrancoFamularo GiuseppeTarsitani PatriziaCastello RobertoPasino Michela Gian Paolo Ceda Marcello Giuseppe MaggioMorganti SimonettaArtoni AndreaGrossi Margherita Stefano Del GiaccoFirinu DavideCostanzo GiuliaArgiolas GiacomoMontalto GiuseppeLicata Anna Filippo Alessandro MontaltoCorica FrancescoBasile GiorgioCatalano AntoninoBellone FedericaPrincipato ConcettoMalatino LorenzoStancanelli BenedettaTerranova Valentina Salvatore Di Marca Rosario Di Quattro Lara La MalfaCaruso RossellaMecocci PatriziaRuggiero CarmelindaBoccardi VirginiaMeschi TizianaTicinesi AndreaNouvenne AntonioMinuz PietroFondrieschi Luigi Giandomenico Nigro ImperialePirisi Mario Gian Paolo FraSola DanieleBellan MattiaPorta MassimoRiva PieroQuadri RobertoLarovere EricaNovelli MarcoScanzi GiorgioMengoli CaterinaProvini StellaRicevuti LauraSimeone EmilioScurti RosaTolloso FabioTarquini RobertoValoriani AliceDolenti SilviaVannini GiuliaVolpi RiccardoBocchi PietroVignali AlessandroHarari SergioLonati ChiaraNapoli FedericoAiello ItaliaLandolfi RaffaeleMontalto MassimoMirijello AntonioPurrello Francesco Antonino Di PinoGhidoni SilviaSalvatore TeresaMonaco LucioRicozzi CarmenPilotto AlbertoIndiano IlariaGandolfo. Federicasubject
medicine.medical_specialtyappropriateness of prescriptionprescribing patternsRenal functionContext (language use)RM1-950Logistic regressionNOchemistry.chemical_compoundolder patientInternal medicinehospital settingmedicinePharmacology (medical)LS4_4Medical prescriptionprescribing patternappropriateness of prescriptions chronic kidney disease hospital setting older patients prescribing patterns real-world data.Original ResearchPharmacologyCreatininereal-world databusiness.industryRetrospective cohort studymedicine.diseaseolder patientsreal-world data.appropriateness of prescriptions; chronic kidney disease; hospital setting; older patients; prescribing patterns; real-world dataappropriateness of prescriptionschemistryObservational studyTherapeutics. Pharmacologybusinesschronic kidney diseaseKidney diseasedescription
Aging with multimorbidity and polytherapy are the most significant factors that could led to inappropriate prescribing of contraindicated medications in patients with chronic kidney disease (CKD). The aim of this study was to evaluate the prescriptions of contraindicated drugs in older adults in CKD and to identify their associated factors in a hospital context. An observational retrospective study was carried out considering all patients ≥65 years with at least one serum creatinine value recorded into the REPOSI register into 2010–2016 period. The estimated glomerular filtration rate (eGFR) was applied to identify CKD. A descriptive analysis was performed to compare demographic and clinical characteristics; logistic regression models were used to estimate factors of inappropriate and percentage changes of drug use during hospitalization. A total of 4,713 hospitalized patients were recorded, of which 49.8% had an eGFR <60 ml/min/1.73 m2; the 21.9% were in treatment with at least one inappropriate drug at the time of hospital admission with a decrease of 3.0% at discharge (p = 0.010). The probability of using at least one contraindicated drug was significantly higher in patients treated with more several drugs (OR 1.21, 95% CI 1.16–1.25, p <0.001) and with CKD end-stages (G4: 16.90, 11.38–25.12, p < 0.001; G5: 19.38, 11.51–32.64, p < 0.001). Low-dose acetylsalicylic acid was the contraindicated drug mainly used at the time of admission, reducing 1.2% at discharge. An overall increase in therapeutic appropriateness in hospitalized older patients with CKD was observed, despite a small percentage of therapeutic inappropriateness at discharge that underlines the need for a closer collaboration with the pharmacologist to improve the drug management.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-10-01 | Frontiers in Pharmacology |