Audit and re-audit of medication use in patients with impaired kidney function

Abstract

Background: Medications prescribed for patients with chronic kidney disease (CKD) often require dose adjustments to ensure safety and efficacy. An audit was undertaken in primary care to assess how appropriate current medication use is in this patient cohort. Aim: To identify medications most likely to be prescribed at inappropriate doses in patients with CKD 3-5. Methods: Level 2 medication reviews were carried out by a clinical pharmacist for patients with a diagnosis of CKD level 3-5. The reviews focused on how appropriate medication use/dosages were where dose reduction or discontinuation would be recommended for patients with poor renal function. The audit was repeated a year later. Findings: Drugs that required creatinine clearance (CrCl) to be calculated had the most interventions: eight patients had dose changes implemented for rivaroxaban. Conclusion: The use of the correct calculation and regular review to assess the use and dose of medications in patients with poor renal function is vital in improving health outcomes.