Evaluation of risk factor management of patients treated on an internal nephrology ward: a pilot study.
BACKGROUND
The objectives of this pilot study were to evaluate treatment quality for the risk factors of hypertension, diabetes and hyperlipidemia as well as the overall treatment quality for patients on an internal nephrology ward. This evaluation included the collection of data concerning the quality of therapeutic drug monitoring, drug use and potential drug-drug interactions. Establishing such baseline information highlights areas that have a need for further therapeutic intervention and creates a foundation for improving patient care, a subject that could be addressed in future clinical pharmacy research projects.


METHODS
Medical charts of patients treated on a single internal nephrology ward were retrospectively evaluated using a predefined data collection form. Assessment of further need for therapeutic intervention was performed.


RESULTS
For 76.5% (n = 78) of the total study population (n = 102), there was either a possibility (39.2%, n = 40) or a need (37.3%, n = 38) for further intervention based on the overall assessment. For the risk factors of hypertension, diabetes and hyperlipidemia, the proportions of patients that require further intervention were 78.8% (n = 71), 90.6% (n = 58) and 87.9% (n = 58), respectively. Patients with diabetes or hyperlipidemia were less likely to have optimal risk factor control. The number of drugs prescribed and the number of potential drug-drug interactions were significantly higher after in-hospital treatment.


CONCLUSIONS
Risk factor treatment needs optimisation. Risk factor management, systematic medication reviews, and screening for and management of potential drug-drug interactions deserve great attention. Clinical pharmacy services could help in the achievement of treatment goals.
Stemer
Gunar
G
Department of Pharmacology and Toxicology, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria. gunar.stemer@akhwien.at
Zehetmayer
Sonja
S
Lemmens-Gruber
Rosa
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D016001:Confidence Intervals; D003920:Diabetes Mellitus / Q000517:prevention & control* / Q000628:therapy; D004347:Drug Interactions; D016903:Drug Monitoring / Q000706:statistics & numerical data; D004358:Drug Therapy / Q000706:statistics & numerical data; D005260:Female; D005919:Glomerular Filtration Rate; D006757:Hospital Units / Q000706:statistics & numerical data*; D006801:Humans; D006949:Hyperlipidemias / Q000517:prevention & control* / Q000628:therapy; D006973:Hypertension / Q000517:prevention & control* / Q000628:therapy; D007674:Kidney Diseases / Q000145:classification / Q000628:therapy*; D007676:Kidney Failure, Chronic / Q000628:therapy; D016030:Kidney Transplantation / Q000534:rehabilitation / Q000706:statistics & numerical data; D008297:Male; D008499:Medical Records; D054539:Medication Therapy Management / Q000706:statistics & numerical data*; D008875:Middle Aged; D009398:Nephrology / Q000706:statistics & numerical data*; D016017:Odds Ratio; D005791:Patient Care / Q000145:classification / Q000706:statistics & numerical data*; D010865:Pilot Projects; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult