A Study on Drug Utilization Review and Potential Drug-Drug Interactions in Chronic Kidney Disease Patients
Background: Chronic kidney disease (CKD) is a worldwide health crisis. Life expectancy increased significantly among CKD patients due to the extensive use of polypharmacy for prescriptions. This predisposes them to potential Drug–Drug Interactions (DDIs). Objectives: The aim of the present study is to evaluate the Drug Utilization Review (DUR) and to assess the potential drug-drug interaction in CKD patients. Methods: This was a prospective observational & analytical study conducted in Sagar Hospitals, Bengaluru. The information collected in the patient profile form, the prescribing pattern was assessed and potential drug–drug interactions were evaluated by using Micromedex, clinirex and drugs.com. Results: This study reveals that the males were more prone to CKD (63%) than females (37%) and the highest percentage of patients in the age group 61-75 years with the average of 66.40 ± 3.92 years. Among all medications the major class of drugs prescribed were anti-hypertensives & the least were drugs acting on thyroid. A total of 547 potential DDIs were observed of which moderate DDI (64.71%) were highest followed by minor(21.75%) & major(13.34%). Based on the statistical analysis performed the prevalence of DDIs in males(61.6%) ,elderly and the patients with two comorbities were reported the highest. With the increase in number of drugs prescribed there was significant increase in the number of DDIs which was statistically proved in the patients prescribed with >16 drugs. Conclusion: The use of polypharmacy for the treatment of multiple co-morbid conditions has been proved to be as one of the most important factors in patients with CKD. Polypharmacy can predispose to drug interactions which results in the failure of the drug therapy and increase in the length of hospital stay. The active participation of clinical pharmacist in clinical activities can help in minimizing the risk and improving the patient care.
