Abstract
Background: It is very important to prescribe appropriate drugs and adjust medication and dosage for optimal disease management not only to maximize patient outcomes, but also to minimize adverse events. So, the accuracy of drug information and consistency among different resources would have a significant effect on drug therapy. Objectives: We aimed to evaluate the concordance among five drug information sources regarding the recommendations for dosage adjustment in renal impairment. Methods: The five drug information resources were selected the Korean National Formulary Drug (KNF), the British national formula 2013 (BNF 65), Daily Med in USA, Lexicomp-online, and Drug Prescribing in Renal Failure (DPRF, 5th ed.). After having classified the degrees of renal function and defined the terms used for the dosing methods, we analyzed the concordance in dosing recommendations in renal deficiency among the information sources by calculating Fleiss Kappa. Results: In the dosing adjustments of patients with renal insufficiency, there were some cases of contraindicated drugs that were not matched in each reference. Statistical analysis of the concordance of four references, except DPRF, and evaluation of 168 of the drugs that were mentioned in all four sources showed the Fleiss Kappa coefficientto be 0.243. This indicatesfair agreement among the data. Conclusion: Fair agreement was observed among 4 sources. This may be owing to discrepancies in the frequency of updating drug information sources. We suggest that the quantitative standard be used to classify renal function and to maintain consistency in definition of renal impairment.
Highlights
Pharmacological therapy is one of the important options for disease management
We aimed to evaluate the concordance among five drug information sources regarding the recommendations for dosage adjustment in renal impairment
In the dosing adjustments of patients with renal insufficiency, there were some cases of contraindicated drugs that were not matched in each reference
Summary
Pharmacological therapy is one of the important options for disease management. It is very important that the occurrence of adverse events be minimized whilemaximizing the therapeutic effect of medication[1]. The prescribers need to use appropriate medications and dosage according to the overall patient status; present illness, underlying disease, liver or kidney function, drug allergy, etc. It has been reported that acute or chronic renal insufficiency can affect the morbidity and mortality rates of patients, especially hospitalized patients [2]. For this reason, dose adjustment according to kidney function is very important to achieve the proper effects and to avoid drug toxicity. In other reports, when the dosage of this medicine was adjusted according to renal function, the incidence of convulsion decreased [5]. Kidney function is generally estimated using parameters such as serum creatinine (Scr), glomerular filtration rate (GFR), and creatinine clearance (Ccr), so it was needed to have the standard of guideline according to renal function index
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
