Analysis of drug prescription in chronic haemodialysis patients.
BACKGROUND
Information concerning medication use in Asian haemodialysis patients is sparse. We surveyed prescribed medications and examined the relation between the number of medications and mortality and clinical characteristics in chronic haemodialysis patients, in Okinawa, Japan.


METHODS
We conducted a cross-sectional multicentre survey in August 1999 and patients were observed during 13 months of follow up.


RESULTS
The clinical demographics of 850 chronic haemodialysis patients in seven dialysis units were obtained. Compared with the mean number of medications prescribed in ambulatory patients treated in general practice reported from Ministry of Health and Welfare of Japan (2.7 (n=20 716)), the mean number medications in haemodialysis patients was larger (7.2 (n=850)). The three most prescribed drug types in haemodialysis patients were those related to calcium and phosphate metabolism (88%), antihypertensive agents (71%), and erythropoietin (60%). Among the 850 patients, 38 died during the 13-month follow-up period. The number of medications was positively associated with mortality after adjusting for age, sex, and other clinical factors: the hazard ratio was 1.14 (95% confidence interval 1.03-1.26, P=0.007). A multiple linear regression analysis using the number of medications as a dependent factor and sex and other clinical characteristics as independent factors revealed that male sex (P=0.04), diabetes mellitus (P<0.0001), and duplication of drugs (P<0.0001) were positively correlated with the number of medications.


CONCLUSIONS
Multiple drug use was observed in haemodialysis patients. The number of prescribed drugs was a significant predictor of short-term mortality. Male sex, diabetes mellitus, and duplication of drugs were correlated with increases in the number of medications.
Tozawa
Masahiko
M
Third Department of Internal Medicine and Dialysis Unit, University of The Ryukyus, Okinawa, Japan. mtozawa@eb.mbn.or.jp
Iseki
Kunitoshi
K
Iseki
Chiho
C
Oshiro
Saori
S
Higashiuesato
Yasushi
Y
Yamazato
Masanobu
M
Tomiyama
Nozomi
N
Tana
Takeshi
T
Takishita
Shuichi
S
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D011307:Drug Prescriptions; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017678:Sex Distribution; D016019:Survival Analysis