Inappropriate prescribing in patients with kidney disease: A rapid review of prevalence, associated clinical outcomes and impact of interventions

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Background: The prevalence of patients with chronic kidney disease (CKD) and polypharmacy is increasing and has amplified the importance of examining inappropriate prescribing (IP) in CKD. This review focuses on the latest research regarding the prevalence of IP in CKD and the related adverse clinical effects and explores new interventions against IP. Method: A literature search was performed using PubMed, EMBASE and the Cochrane Library searching articles published between June 2016 and March 2022. Results: Twenty-seven studies were included. An IP prevalence of 12.6% to 96% and 0.3% to 66% was reported in hospital and outpatient settings, respectively. In nonhospital settings, the prevalence of IP varied between 3.9% and 60%. IP was associated with higher risk of hospitalisation (HR 1.46, 95% CI 1.17–1.81), higher bleeding rate (HR 2.34, 95% CI 1.32 to 3.37) and higher risk of all-cause mortality (OR 1.07, 95% CI 1.02 to 1.13). Three studies reported the impact of interventions on IP. Conclusion: This review highlights widespread IP in CKD patients across healthcare settings, with varying prevalence rates. IP is substantially linked to adverse outcomes in patients. While limited interventions show promise, urgent research is needed to develop effective strategies addressing IP and improving CKD patient care.

OriginalsprogEngelsk
TidsskriftBasic and Clinical Pharmacology and Toxicology
Vol/bind134
Udgave nummer4
Sider (fra-til)439-459
ISSN1742-7835
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
The research was funded by unrestricted grants from The Hospitals Pharmacies' and Amgros' Research Development Foundation, Dampfærgevej 22, Copenhagen, Denmark. Morten Baltzer Houlind is supported by the BRIDGE—Translational Excellence Program ( bridge.ku.dk ) at the Faculty of Health and Medical Sciences, University of Copenhagen, funded by the Novo Nordisk Foundation (grant No. NNF20SA0064340). These funders had no role in the design of this study and will not have any role during its execution, analyses, interpretation of the data or decision to submit results. Funding information

Publisher Copyright:
© 2024 The Authors. Basic & Clinical Pharmacology & Toxicology published by John Wiley & Sons Ltd on behalf of Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

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