Title:Chronic Kidney Disease (CKD) - A Brand Ambassador/Alarming Bell for
Potentially Inappropriate Medication in Elderly Inpatients
Volume: 15
Issue: 1
Author(s): Rishabh Sharma*, Parveen Bansal, Manik Chhabra and Malika Arora
Affiliation:
- Department of Pharmacy Practice, Indo Soviet Friendship College of Pharmacy, Moga, Punjab, India
Keywords:
Beers criteria, elderly inpatient, American Geriatric Society, potentially inappropriate medication, comorbidities, chronic kidney disease.
Abstract: Background: Since the past decade, prevalence of Potentially Inappropriate Medication
(PIM) among elderly inpatients has increased drastically. However, limited data is available on
PIM indicators and PIMs use among the elderly in patients suffering from Chronic Kidney Disease
(CKD).
Objective: The objective of this study is to determine the prevalence of PIMs in elderly hospitalized
patients with CKD.
Methods: A cross-sectional study was carried out on 102 patients in a tertiary care hospital. PIMs
were identified using Beers criteria 2019. Chi-square test was used to identify the association between
variables and PIMs use.
Results: PIMs, as assessed according to AGS updated Beers criteria 2019 was found to be in more
than 68.6% of patients of median age 65 years and 3 diagnoses and 7 days median length of stay.
Most of the patients (47.1%) had ≥4 diagnosis. The most common comorbidities in patient were diabetes
mellitus (n=54) and hypertension (n=55). Most of the subjects (66.7%) were on polypharmacy
(5-9 medications/day) and 25.5% were on a higher level of polypharmacy (>10 medicines/day).
Approximately 90% of the patients were having very low CrCl < 21ml/min (calculated with the
help of Cockcroft- Gault formula). A significant association between PIM use and an increased
number of diagnoses, polypharmacy or high-level polypharmacy, was observed.
Conclusion: The prevalence of PIMs in elderly inpatients suffering from CKD is quite high. The
study clearly indicates negligence/ lack of awareness amongst physicians leading to increase in
PIM use. Authors propose that the CKD patients should attract special attention of physician and
should be treated as brand ambassadors/alarming bell for PIM use.
