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Adherence with Dosing Guideline in Patients with Impaired Renal Function at Hospital Discharge.
Drenth-van Maanen, A Clara; van Marum, Rob J; Jansen, Paul A F; Zwart, Jeannette E F; van Solinge, Wouter W; Egberts, Toine C G.
Afiliación
  • Drenth-van Maanen AC; University Medical Center Utrecht, Department of Geriatrics, Utrecht, The Netherlands; Expertise Centre Pharmacotherapy for Old persons (Ephor), Utrecht, The Netherlands.
  • van Marum RJ; Expertise Centre Pharmacotherapy for Old persons (Ephor), Utrecht, The Netherlands; Jeroen Bosch Hospital, Department of Geriatrics, 's-Hertogenbosch, The Netherlands; VUmc, Department of General Practice & Elderly Care Medicine, EMGO+ Institute for Health and Care Research, Amsterdam, The Nethe
  • Jansen PA; University Medical Center Utrecht, Department of Geriatrics, Utrecht, The Netherlands; Expertise Centre Pharmacotherapy for Old persons (Ephor), Utrecht, The Netherlands.
  • Zwart JE; University Medical Center Utrecht, Department of Clinical Pharmacy, Utrecht, The Netherlands.
  • van Solinge WW; University Medical Center Utrecht, Department of Clinical Chemistry and Haematology, Utrecht, The Netherlands.
  • Egberts TC; Expertise Centre Pharmacotherapy for Old persons (Ephor), Utrecht, The Netherlands; University Medical Center Utrecht, Department of Clinical Pharmacy, Utrecht, The Netherlands; Utrecht Institute for Pharmaceutical Sciences (UIPS), Department of Pharmacoepidemiology and Pharmacotherapy, Faculty of S
PLoS One ; 10(6): e0128237, 2015.
Article en En | MEDLINE | ID: mdl-26053481
OBJECTIVES: To determine the prevalence, determinants, and potential clinical relevance of adherence with the Dutch dosing guideline in patients with impaired renal function at hospital discharge. DESIGN: Retrospective cohort study between January 2007 and July 2011. SETTING: Academic teaching hospital in the Netherlands. SUBJECTS: Patients with an estimated glomerular filtration rate (eGFR) between 10-50 ml/min/1.73 m(2) at discharge and prescribed one or more medicines of which the dose is renal function dependent. MAIN OUTCOME MEASURES: The prevalence of adherence with the Dutch renal dosing guideline was investigated, and the influence of possible determinants, such as reporting the eGFR and severity of renal impairment (severe: eGFR<30 and moderate: eGFR 30-50 ml/min/1.73 m(2)). Furthermore, the potential clinical relevance of non-adherence was assessed. RESULTS: 1327 patients were included, mean age 67 years, mean eGFR 38 ml/min/1.73 m(2). Adherence with the guideline was present in 53.9% (n=715) of patients. Reporting the eGFR, which was incorporated since April 2009, resulted in more adherence with the guideline: 50.7% vs. 57.0%, RR 1.12 (95% CI 1.02-1.25). Adherence was less in patients with severe renal impairment (46.0%), compared to patients with moderate renal impairment (58.1%, RR 0.79; 95% CI 0.70-0.89). 71.4% of the cases of non-adherence had the potential to cause moderate to severe harm. CONCLUSION: Required dosage adjustments in case of impaired renal function are often not performed at hospital discharge, which may cause harm to the majority of patients. Reporting the eGFR can be a small and simple first step to improve adherence with dosing guidelines.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 11_ODS3_cobertura_universal Problema de salud: 11_delivery_arrangements Asunto principal: Alta del Paciente / Cooperación del Paciente / Guías de Práctica Clínica como Asunto / Hospitales / Pruebas de Función Renal Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2015 Tipo del documento: Article País de afiliación: Países Bajos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 11_ODS3_cobertura_universal Problema de salud: 11_delivery_arrangements Asunto principal: Alta del Paciente / Cooperación del Paciente / Guías de Práctica Clínica como Asunto / Hospitales / Pruebas de Función Renal Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2015 Tipo del documento: Article País de afiliación: Países Bajos
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