Self-reported medication adherence and adverse patient safety events in CKD

Kailin L. Hsu, Jeffrey C. Fink, Jennifer S. Ginsberg, Marni Yoffe, Min Zhan, Wanda Fink, Corinne M. Woods, Clarissa Diamantidis

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)621-629
Number of pages9
JournalAmerican Journal of Kidney Diseases
Volume66
Issue number4
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Medication Adherence
Patient Safety
Glomerular Filtration Rate
Safety
Kidney
Pharmaceutical Preparations
Social Adjustment
Hyperkalemia
Hypoglycemia
Hypotension
Cohort Studies
Cross-Sectional Studies
Prospective Studies
Guidelines

Keywords

  • adverse safety event
  • chronic kidney disease (CKD)
  • drug-related problem (DRP)
  • medication adherence
  • patient safety
  • polypharmacy
  • Reduced kidney function
  • Safe Kidney Care (SKC) Cohort Study
  • treatment compliance

ASJC Scopus subject areas

  • Nephrology

Cite this

Self-reported medication adherence and adverse patient safety events in CKD. / Hsu, Kailin L.; Fink, Jeffrey C.; Ginsberg, Jennifer S.; Yoffe, Marni; Zhan, Min; Fink, Wanda; Woods, Corinne M.; Diamantidis, Clarissa.

In: American Journal of Kidney Diseases, Vol. 66, No. 4, 01.01.2015, p. 621-629.

Research output: Contribution to journalArticle

Hsu, Kailin L. ; Fink, Jeffrey C. ; Ginsberg, Jennifer S. ; Yoffe, Marni ; Zhan, Min ; Fink, Wanda ; Woods, Corinne M. ; Diamantidis, Clarissa. / Self-reported medication adherence and adverse patient safety events in CKD. In: American Journal of Kidney Diseases. 2015 ; Vol. 66, No. 4. pp. 621-629.
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AU - Zhan, Min

AU - Fink, Wanda

AU - Woods, Corinne M.

AU - Diamantidis, Clarissa

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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.

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