Drug Dosing in Patients with Renal Insufficiency in a Hospital Setting using Electronic Prescribing and Automated Reporting of Estimated Glomerular Filtration Rate
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| Název: | Drug Dosing in Patients with Renal Insufficiency in a Hospital Setting using Electronic Prescribing and Automated Reporting of Estimated Glomerular Filtration Rate |
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| Autoři: | Court Pedersen, Mads Nybo, Anita Nymark, Jens Søndergaard, Christianna Marinakis, Daniel Pilsgaard Henriksen, Anita L. Nielsen, Henrik Birn, Annemarie Hellebek |
| Zdroj: | Nielsen, A L, Henriksen, D P, Marinakis, C, Hellebek, A, Birn, H, Nybo, M, Søndergaard, J, Nymark, A & Pedersen, C 2014, ' Drug Dosing in Patients with Renal Insufficiency in a Hospital Setting using Electronic Prescribing and Automated Reporting of Estimated Glomerular Filtration Rate ', Basic & Clinical Pharmacology & Toxicology, vol. 114, no. 5, pp. 407-413 . https://doi.org/10.1111/bcpt.12185 Nielsen, A L, Henriksen, D P, Marinakis, C, Hellebek, A, Birn, H, Nybo, M, Søndergaard, J, Nymark, A & Pedersen, C 2014, 'Drug dosing in patients with renal insufficiency in a hospital setting using electronic prescribing and automated reporting of estimated glomerular filtration rate', Basic & Clinical Pharmacology & Toxicology, vol. 114, no. 5, pp. 407-13. https://doi.org/10.1111/bcpt.12185 |
| Informace o vydavateli: | Wiley, 2014. |
| Rok vydání: | 2014 |
| Témata: | Adult, Male, Adolescent, Drug-Related Side Effects and Adverse Reactions, Observational Study, Renal Insufficiency/physiopathology, Inappropriate Prescribing, Practice Patterns, Physicians'/standards, Dose-Response Relationship, Hospitals, University, Young Adult, Electronic Prescribing, 03 medical and health sciences, 0302 clinical medicine, Journal Article, 80 and over, Humans, Medication Errors, Practice Patterns, Physicians'/standards, Renal Insufficiency, Practice Patterns, Physicians', Aged, Aged, 80 and over, University, Pharmaceutical Preparations/administration & dosage, Dose-Response Relationship, Drug, Research Support, Non-U.S. Gov't, Electronic Prescribing/standards, Middle Aged, Hospitals, 3. Good health, Hospitalization, Drug-Related Side Effects and Adverse Reactions/prevention & control, Inappropriate Prescribing/statistics & numerical data, Pharmaceutical Preparations, Practice Guidelines as Topic, Medication Errors/prevention & control, Female, Guideline Adherence, Drug, Glomerular Filtration Rate |
| Popis: | In patients with impaired renal function, drug dose adjustment is often required. Non‐adherence to clinical prescribing recommendations may result in severe adverse events. In previous studies, the prevalence rate of non‐adherence to recommended dosing has been reported to be 19–67%. Using the clinical support system Renbase® as reference, we investigated the use and dosing of drugs in patients with impaired renal function in a university hospital setting using electronic prescription and automatic reporting of estimated glomerular filtration rate (eGFR). In all, 232 patients with an eGFR in the range of 10–49 ml/min./1.73 m2 were included. We identified 436 episodes with administration of renal risk drugs (prescribed to 183 patients): 410 drugs required dose adjustment according to the eGFR and 26 should be avoided. In total, the use or dosing of 66 (15%) of the 436 renal risk drugs was not in agreement with recommendations in Renbase®. This reflects less disagreement with expert guidelines than reported previously, indicating a possible beneficial effect of electronic prescribing and reporting of eGFR. However, we also found that disagreement to some extent reflected inappropriate drug use. We conclude that despite implementation of electronic prescribing and automated reporting of eGFR, patients with renal insufficiency may still be exposed to inappropriate drug use, with potential increased risk of adverse effects. Initiatives to reduce medication errors such as the use of electronic decision support systems should be explored. |
| Druh dokumentu: | Article |
| Jazyk: | English |
| ISSN: | 1742-7843 1742-7835 |
| DOI: | 10.1111/bcpt.12185 |
| Přístupová URL adresa: | https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/bcpt.12185 https://pubmed.ncbi.nlm.nih.gov/24373255 https://portal.findresearcher.sdu.dk/da/publications/drug-dosing-in-patients-with-renal-insufficiency-in-a-hospital-se https://onlinelibrary.wiley.com/doi/pdf/10.1111/bcpt.12185 http://findresearcher.sdu.dk/portal/da/publications/drug-dosing-in-patients-with-renal-insufficiency-in-a-hospital-setting-using-electronic-prescribing-and-automated-reporting-of-estimated-glomerular-filtration-rate(4bbb7b01-4334-4ea6-bb07-dba1e8c00849).html http://www.ncbi.nlm.nih.gov/pubmed/24373255 https://onlinelibrary.wiley.com/doi/10.1111/bcpt.12185 https://core.ac.uk/display/50693177 https://portal.findresearcher.sdu.dk/da/publications/4bbb7b01-4334-4ea6-bb07-dba1e8c00849 https://portal.findresearcher.sdu.dk/da/publications/4bbb7b01-4334-4ea6-bb07-dba1e8c00849 https://doi.org/10.1111/bcpt.12185 https://pure.au.dk/portal/en/publications/ada1565c-5ae0-4df9-a986-e9c42def39cd https://doi.org/10.1111/bcpt.12185 |
| Rights: | Wiley Online Library User Agreement |
| Přístupové číslo: | edsair.doi.dedup.....2ea323ae7b67fe35697e7a02436399c1 |
| Databáze: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstrakt: | In patients with impaired renal function, drug dose adjustment is often required. Non‐adherence to clinical prescribing recommendations may result in severe adverse events. In previous studies, the prevalence rate of non‐adherence to recommended dosing has been reported to be 19–67%. Using the clinical support system Renbase® as reference, we investigated the use and dosing of drugs in patients with impaired renal function in a university hospital setting using electronic prescription and automatic reporting of estimated glomerular filtration rate (eGFR). In all, 232 patients with an eGFR in the range of 10–49 ml/min./1.73 m2 were included. We identified 436 episodes with administration of renal risk drugs (prescribed to 183 patients): 410 drugs required dose adjustment according to the eGFR and 26 should be avoided. In total, the use or dosing of 66 (15%) of the 436 renal risk drugs was not in agreement with recommendations in Renbase®. This reflects less disagreement with expert guidelines than reported previously, indicating a possible beneficial effect of electronic prescribing and reporting of eGFR. However, we also found that disagreement to some extent reflected inappropriate drug use. We conclude that despite implementation of electronic prescribing and automated reporting of eGFR, patients with renal insufficiency may still be exposed to inappropriate drug use, with potential increased risk of adverse effects. Initiatives to reduce medication errors such as the use of electronic decision support systems should be explored. |
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| ISSN: | 17427843 17427835 |
| DOI: | 10.1111/bcpt.12185 |