Patterns of drug use and polypharmacy burden in chronic kidney disease patients: Anexperience from a secondary care hospital in United Arab Emirates.

Abstract

To evaluate the patterns of drug use and polypharmacy burden in patients with chronic kidney disease (CKD). It was a prospective observational cohort study done in a secondary care hospital in Ras Al Khaimah, United Arab Emirates (UAE). 130 CKD patients admitted under the care of nephrology in-patient department including those undergoing regular maintenance hemodialysis were included in the study. Electronic patient case records of CKD patients were studied and analyzed to evaluate drug use pattern and medication burden. The majority of the study patients were in CKD stage G5 (82.3%, 107/130). The median number of different drugs prescribed per patient was found to be 11.0. Negative binomial regression analysis revealed that CKD patients with more than 4 comorbidities were prescribed 1.27 times more than patients with ≤ 4 comorbidities (IRR: 1.273, p=0.017). Patients with dyslipidemia (IRR: 1.393, p < 0.001) and hyperphosphatemia (IRR: 1.189, p=0.048) as comorbid conditions were more likely to be prescribed a higher number of drugs than patients without these comorbid conditions. With every 1-day increase in length of hospital stay, the likelihood of drug prescription also increased 1.01 times (IRR: 1.01, p=0.040). Multivariate logistic regression analysis identified older age (OR:1.07, p=0.004), higher number of comorbidities (OR: 9.58, p=0.011), comorbid conditions like dyslipidemia (OR: 43.7, p=0.001), and hyperphosphatemia (OR: 17.18, p=0.044) as independent predictors of polypharmacy in our study population. The study represents the current drug use pattern among CKD patients in a secondary care hospital in UAE. Study findings highlight that medication burden in CKD patients was high, and the majority of them were on polypharmacy.