title: Awareness and knowledge among internal medicine house-staff for dose adjustment of commonly used medications in patients with CKD.
abstract: Drug dosing errors result in adverse patient outcomes and are more common in patients with chronic kidney disease (CKD). As internists treat the majority of patients with CKD, we study if Internal Medicine house-staff have awareness and knowledge about the correct dosage of commonly used medications for those with CKD.
  
  
  
  A cross-sectional survey was performed and included 341 participants. The outcomes were the awareness of whether a medication needs dose adjustment in patients with CKD and whether there was knowledge for the level of glomerular filtration rate (GFR) a medication needs to be adjusted.
  
  
  
  The overall pattern for all post-graduate year (PGY) groups in all medication classes was a lack of awareness and knowledge. For awareness, there were statistically significant increased mean differences for PGY2 and PGY3 as compared to PGY1 for allergy, endocrine, gastrointestinal, and rheumatologic medication classes but not for analgesic, cardiovascular, and neuropsychotropic medication classes. For knowledge, there were statistically significant increased mean differences for PGY2 and PGY3 as compared to PGY1 for allergy, cardiovascular, endocrine, and gastrointestinal, medication classes but not for analgesic, neuropsychotropic, and rheumatologic medication classes.
  
  
  
  Internal Medicine house-staff across all levels of training demonstrated poor awareness and knowledge for many medication classes in CKD patients. Internal Medicine house-staff should receive more nephrology exposure and formal didactic educational training during residency to better manage complex treatment regimens and prevent medication dosing errors.
authors.affiliation: Nephrology Division, Department of Medicine, Nassau University Medical Center, 2201 Hempstead Turnpike, Box 49, East Meadow, NY, 11554, USA.
authors.forename: Sikander
authors.initials: S
authors.lastname: Surana
authors.affiliation: Nephrology Division, Department of Medicine, Nassau University Medical Center, 2201 Hempstead Turnpike, Box 49, East Meadow, NY, 11554, USA.
authors.forename: Neeru
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Nephrology Division, Department of Medicine, Nassau University Medical Center, 2201 Hempstead Turnpike, Box 49, East Meadow, NY, 11554, USA.
authors.forename: Amita
authors.initials: A
authors.lastname: Vasudeva
authors.affiliation: Nephrology Division, Department of Medicine, Nassau University Medical Center, 2201 Hempstead Turnpike, Box 49, East Meadow, NY, 11554, USA.
authors.forename: Gulvahid
authors.initials: G
authors.lastname: Shaikh
authors.affiliation: Nephrology Division, Department of Medicine, North Shore University Hospital, 100 Community Dr, Manhasset, NY, 11030, USA.
authors.forename: Kenar D
authors.initials: KD
authors.lastname: Jhaveri
authors.affiliation: Nephrology Division, Department of Medicine, North Shore University Hospital, 100 Community Dr, Manhasset, NY, 11030, USA.
authors.forename: Hitesh
authors.initials: H
authors.lastname: Shah
authors.affiliation: Nephrology Division, Department of Medicine, North Shore University Hospital, 100 Community Dr, Manhasset, NY, 11030, USA.
authors.forename: Deepa
authors.initials: D
authors.lastname: Malieckal
authors.affiliation: Department of Business Management, Brooklyn College, 2900 Bedford Ave, Brooklyn, NY, 11210, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Fogel
authors.affiliation: Nephrology Division, Department of Medicine, Nassau University Medical Center, 2201 Hempstead Turnpike, Box 49, East Meadow, NY, 11554, USA.
authors.forename: Gurwinder
authors.initials: G
authors.lastname: Sidhu
authors.affiliation: Nephrology Division, Department of Medicine, Nassau University Medical Center, 2201 Hempstead Turnpike, Box 49, East Meadow, NY, 11554, USA. srubinst@numc.edu.
authors.forename: Sofia
authors.identifier: 0000-0002-4805-9736
authors.initials: S
authors.lastname: Rubinstein
mesh_terms: D000328:Adult; D000700:Analgesics / Q000008:administration & dosage; D018926:Anti-Allergic Agents / Q000008:administration & dosage; D018501:Antirheumatic Agents / Q000008:administration & dosage; D002317:Cardiovascular Agents / Q000008:administration & dosage; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007388:Internal Medicine / Q000193:education*; D008297:Male; D008505:Medical Staff, Hospital; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D011619:Psychotropic Drugs / Q000008:administration & dosage; D051436:Renal Insufficiency, Chronic; D011795:Surveys and Questionnaires
chemical_list: D000700:Analgesics; D018926:Anti-Allergic Agents; D018501:Antirheumatic Agents; D002317:Cardiovascular Agents; D005765:Gastrointestinal Agents; D007004:Hypoglycemic Agents; D004364:Pharmaceutical Preparations; D011619:Psychotropic Drugs
keywords: Chronic kidney disease; Dosing errors; Internal medicine; Internship and residency; Medication dose adjustment