July 1982

Prescribing Medication in Long-term Dialysis Units

Author Affiliations

From the University of Colorado Health Sciences Center, Denver (Drs Anderson, Melikian, and Goldberg); the Department of Pharmacy, University of California, San Francisco (Dr Gambertoglio); North Central Dialysis Centers, Chicago (Dr Berns); Department of Medicine, Wayne State Medical Center, Detroit (Dr Cadnapaphornchai); Veterans Administration Hospital, Omaha (Dr Egan); VA Hospital, Dallas (Dr Henrich); Billings (Mont) Clinic (Dr Hicks); Charlotte Hungerford Hospital, Torrington, Conn (Dr Kovalchik); and Greensboro (NC) Kidney Center (Dr Olin).

Arch Intern Med. 1982;142(7):1305-1308. doi:10.1001/archinte.1982.00340200063016

• Little information is available regarding the current patterns of medication use in long-term dialysis centers. Therefore, we surveyed the medication records of 1,023 patients undergoing long-term dialysis therapy in 27 dialysis centers. The mean number of medications prescribed per patient was 7.7 ± 0.54, while 24% of patients were receiving ten or more medications. Increasing patient age, increasing duration of dialysis, in-center dialysis, and the presence of underlying diabetic and hypertensive nephropathy were associated with increased frequency of medication use. The use of multiple pharmacologic agents was associated with a high frequency of drug duplication (12%), potential dosage error (9%), potential significant drug interaction (15%), and use of contraindicated drugs (2.5%). A lack of individualization of the use of several pharmacologic agents was apparent. An extreme degree of center variability in drug use was also apparent. Periodic review of medication use should be undertaken in the long-term dialysis setting.

(Arch Intern Med 1982;142:1305-1308)