Identification of Prescribing Patterns in Hemodialysis Outpatients Taking Multiple Medications

We investigated the relationship between multidrug administration and the characteristics, pathophysiology, and drug class in outpatients with hemodialysis. A retrospective cross-sectional study was conducted at Saitama Medical University Hospital in October 2018. Multidrug administration was define...

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Main Authors: Hiroyuki Nagano, Koji Tomori, Mano Koiwa, Shotaro Kobayashi, Masahiro Takahashi, Hideki Makabe, Hirokazu Okada, Akifumi Kushiyama
Format: Article
Language:English
Published: MDPI AG 2023-02-01
Series:Pharmacy
Subjects:
Online Access:https://www.mdpi.com/2226-4787/11/2/43
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author Hiroyuki Nagano
Koji Tomori
Mano Koiwa
Shotaro Kobayashi
Masahiro Takahashi
Hideki Makabe
Hirokazu Okada
Akifumi Kushiyama
author_facet Hiroyuki Nagano
Koji Tomori
Mano Koiwa
Shotaro Kobayashi
Masahiro Takahashi
Hideki Makabe
Hirokazu Okada
Akifumi Kushiyama
author_sort Hiroyuki Nagano
collection DOAJ
description We investigated the relationship between multidrug administration and the characteristics, pathophysiology, and drug class in outpatients with hemodialysis. A retrospective cross-sectional study was conducted at Saitama Medical University Hospital in October 2018. Multidrug administration was defined as receiving either more than six drugs or more than the median number of drugs. The drugs used were represented by their anatomical classification codes in the Anatomical Therapeutic Chemistry Classification System (ATC classification). A latent class analysis (LCA) was used to identify clusters at risk of receiving multiple medications. A stepwise logistic regression analysis was performed to select ATC classifications prone to being involved in multidrug administration. As of October 2018, 98 outpatients with hemodialysis were enrolled in the study. In the LCA, when diabetes was the main primary disease, oral hypoglycemic agents available to dialysis patients were limited, but the number of drugs administered was large. Old age, poor nourishment, a long history of dialysis, and chronic nephritis were associated with multidrug administration among nondiabetic patients. In the second level of the ATC classification, the drugs frequently used were coded A02 (drugs for acid-related disorders), A07 (antidiarrheal agents, intestinal anti-inflammatory/anti-infective agents), B01 (antithrombotic agents), and N05 (psycholeptics). The prescribing patterns for either diabetic patients or nondiabetic elderly patients were identified in outpatients with hemodialysis taking multiple medications, and drugs for acid-related disorders, antidiarrheal agents, intestinal anti-inflammatory/anti-infective agents, antithrombotic agents, and psycholeptics are frequently used in those patients.
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spelling doaj.art-539bc0adc7b643e197e994af07fc1e462023-11-17T20:55:52ZengMDPI AGPharmacy2226-47872023-02-011124310.3390/pharmacy11020043Identification of Prescribing Patterns in Hemodialysis Outpatients Taking Multiple MedicationsHiroyuki Nagano0Koji Tomori1Mano Koiwa2Shotaro Kobayashi3Masahiro Takahashi4Hideki Makabe5Hirokazu Okada6Akifumi Kushiyama7Department of Pharmacy, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, JapanDepartment of Nephrology, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, JapanDepartment of Pharmacy, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, JapanDepartment of Pharmacotherapy, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose-shi, Tokyo 204-8588, JapanDepartment of Pharmacotherapy, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose-shi, Tokyo 204-8588, JapanDepartment of Pharmacy, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, JapanDepartment of Nephrology, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, JapanDepartment of Pharmacotherapy, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose-shi, Tokyo 204-8588, JapanWe investigated the relationship between multidrug administration and the characteristics, pathophysiology, and drug class in outpatients with hemodialysis. A retrospective cross-sectional study was conducted at Saitama Medical University Hospital in October 2018. Multidrug administration was defined as receiving either more than six drugs or more than the median number of drugs. The drugs used were represented by their anatomical classification codes in the Anatomical Therapeutic Chemistry Classification System (ATC classification). A latent class analysis (LCA) was used to identify clusters at risk of receiving multiple medications. A stepwise logistic regression analysis was performed to select ATC classifications prone to being involved in multidrug administration. As of October 2018, 98 outpatients with hemodialysis were enrolled in the study. In the LCA, when diabetes was the main primary disease, oral hypoglycemic agents available to dialysis patients were limited, but the number of drugs administered was large. Old age, poor nourishment, a long history of dialysis, and chronic nephritis were associated with multidrug administration among nondiabetic patients. In the second level of the ATC classification, the drugs frequently used were coded A02 (drugs for acid-related disorders), A07 (antidiarrheal agents, intestinal anti-inflammatory/anti-infective agents), B01 (antithrombotic agents), and N05 (psycholeptics). The prescribing patterns for either diabetic patients or nondiabetic elderly patients were identified in outpatients with hemodialysis taking multiple medications, and drugs for acid-related disorders, antidiarrheal agents, intestinal anti-inflammatory/anti-infective agents, antithrombotic agents, and psycholeptics are frequently used in those patients.https://www.mdpi.com/2226-4787/11/2/43multidrug administrationhemodialysisATC classificationLCA
spellingShingle Hiroyuki Nagano
Koji Tomori
Mano Koiwa
Shotaro Kobayashi
Masahiro Takahashi
Hideki Makabe
Hirokazu Okada
Akifumi Kushiyama
Identification of Prescribing Patterns in Hemodialysis Outpatients Taking Multiple Medications
Pharmacy
multidrug administration
hemodialysis
ATC classification
LCA
title Identification of Prescribing Patterns in Hemodialysis Outpatients Taking Multiple Medications
title_full Identification of Prescribing Patterns in Hemodialysis Outpatients Taking Multiple Medications
title_fullStr Identification of Prescribing Patterns in Hemodialysis Outpatients Taking Multiple Medications
title_full_unstemmed Identification of Prescribing Patterns in Hemodialysis Outpatients Taking Multiple Medications
title_short Identification of Prescribing Patterns in Hemodialysis Outpatients Taking Multiple Medications
title_sort identification of prescribing patterns in hemodialysis outpatients taking multiple medications
topic multidrug administration
hemodialysis
ATC classification
LCA
url https://www.mdpi.com/2226-4787/11/2/43
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