TY - JOUR
T1 - Self-reported medication adherence and adverse patient safety events in CKD
AU - Hsu, Kailin L.
AU - Fink, Jeffrey C.
AU - Ginsberg, Jennifer S.
AU - Yoffe, Marni
AU - Zhan, Min
AU - Fink, Wanda
AU - Woods, Corinne M.
AU - Diamantidis, Clarissa J.
N1 - Funding Information:
Support: The work included in this report was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (grant R01-DK084017 ; Ms Ginsberg, Dr Zhan, Ms Woods, and Dr Fink) and in part by the National Institute on Aging Short-Term Training Program on Aging Grant ( T35AG036679 ; Ms Hsu) to the University of Maryland School of Medicine and the University of Maryland Clinical Translational Science Institute and the University of Maryland General Clinical Research Center. The funders of this study had no role in study design; collection, analysis, and interpretation of data; writing the report; or the decision to submit the report for publication.
Funding Information:
Financial Disclosure: Dr Fink has received prior research funding from Amgen Inc and honoraria from Sandoz Inc and Amgen Inc. The other authors declare that they have no other relevant financial interests.
Publisher Copyright:
© 2015 National Kidney Foundation, Inc.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Background Promoting medication adherence is a recognized challenge for prescribers. In this study, we examine whether lower medication adherence is associated with adverse safety events in individuals with decreased estimated glomerular filtration rates (eGFRs). Study Design Cross-sectional baseline analysis of prospective cohort. Setting & Participants Baseline analysis of the Safe Kidney Care (SKC) Cohort Study, a prospective study of individuals with eGFRs < 60 mL/min/1.73 m2 intended to assess the incidence of disease-specific safety events. Kidney transplant recipients were excluded. Predictor Self-reported medication adherence based on responses to 3 questions ascertaining degree of medication regimen adherence. Outcomes Adverse safety events were self-reported at baseline (class I events), such as hypoglycemia or fall thought to be related to a medication, or detected incidentally during the baseline visit (class II events), for example, hypotension or hyperkalemia. Potential drug-related problems (DRPs) were determined by analyzing participants' medications with respect to dosing guidelines based on their screening eGFRs at the time of medication reporting. Measurements Relationship between medication adherence and disease-specific patient safety events. Results Of 293 SKC participants, 154 (53%) were classified as having lower medication adherence. After multivariable adjustment, lower medication adherence was significantly associated with a class I or II safety event (prevalence ratio [PR], 1.21; 95% CI, 1.04-1.41) and potential DRPs (PR, 1.29; 95% CI, 1.02-1.63). Lower medication adherence was also significantly associated with multiple (≥2) class I events (PR, 1.71; 95% CI, 1.18-2.49), multiple class I or II events (PR, 1.35; 95% CI, 1.04-1.76), and multiple potential DRPs (PR, 2.11; 95% CI, 1.08-2.69) compared with those with higher medication adherence. Limitations Use of self-reported medication adherence rather than pharmacy records. Clinical relevance of detected safety events is unclear. Conclusions Lower medication adherence is associated with adverse safety events in individuals with eGFRs < 60 mL/min/1.73 m2.
AB - Background Promoting medication adherence is a recognized challenge for prescribers. In this study, we examine whether lower medication adherence is associated with adverse safety events in individuals with decreased estimated glomerular filtration rates (eGFRs). Study Design Cross-sectional baseline analysis of prospective cohort. Setting & Participants Baseline analysis of the Safe Kidney Care (SKC) Cohort Study, a prospective study of individuals with eGFRs < 60 mL/min/1.73 m2 intended to assess the incidence of disease-specific safety events. Kidney transplant recipients were excluded. Predictor Self-reported medication adherence based on responses to 3 questions ascertaining degree of medication regimen adherence. Outcomes Adverse safety events were self-reported at baseline (class I events), such as hypoglycemia or fall thought to be related to a medication, or detected incidentally during the baseline visit (class II events), for example, hypotension or hyperkalemia. Potential drug-related problems (DRPs) were determined by analyzing participants' medications with respect to dosing guidelines based on their screening eGFRs at the time of medication reporting. Measurements Relationship between medication adherence and disease-specific patient safety events. Results Of 293 SKC participants, 154 (53%) were classified as having lower medication adherence. After multivariable adjustment, lower medication adherence was significantly associated with a class I or II safety event (prevalence ratio [PR], 1.21; 95% CI, 1.04-1.41) and potential DRPs (PR, 1.29; 95% CI, 1.02-1.63). Lower medication adherence was also significantly associated with multiple (≥2) class I events (PR, 1.71; 95% CI, 1.18-2.49), multiple class I or II events (PR, 1.35; 95% CI, 1.04-1.76), and multiple potential DRPs (PR, 2.11; 95% CI, 1.08-2.69) compared with those with higher medication adherence. Limitations Use of self-reported medication adherence rather than pharmacy records. Clinical relevance of detected safety events is unclear. Conclusions Lower medication adherence is associated with adverse safety events in individuals with eGFRs < 60 mL/min/1.73 m2.
KW - Reduced kidney function
KW - Safe Kidney Care (SKC) Cohort Study
KW - adverse safety event
KW - chronic kidney disease (CKD)
KW - drug-related problem (DRP)
KW - medication adherence
KW - patient safety
KW - polypharmacy
KW - treatment compliance
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U2 - 10.1053/j.ajkd.2015.03.026
DO - 10.1053/j.ajkd.2015.03.026
M3 - Article
C2 - 25979348
AN - SCOPUS:84942296979
SN - 0272-6386
VL - 66
SP - 621
EP - 629
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 4
ER -