KHẢO SÁT TÌNH HÌNH SỬ DỤNG THUỐC TRÊN BỆNH NHÂN BỆNH THẬN MẠN ĐIỀU TRỊ NỘI TRÚ TẠI MỘT BỆNH VIỆN HẠNG 1, THÀNH PHỐ HỒ CHÍ MINH

Abstract

Background: Patients with chronic kidney disease (CKD) usually have multiple comorbidities and  require polypharmacy. Therefore, assessment of medication use in CKD patients is crucial to improve treatment effectiveness and safety. Objectives: To investigate characteristics of patients, of drug – related problems (DRPs), and factors associated with DRP occurrence. Materials and methods: A cross – sectional study was conducted on medical records of hospitalized patients with CKD treated at the Department of Nephrology – Hemodialysis in a provincial hospital, Ho Chi Minh City, between 1^st September 2024 and 31^st December 2024. DRPs were identified and classified according to the Pharmaceutical Care Network Europe classification system, version 9.1, with following references: Summary of Product Characteristics, current treatment guidelines of the Vietnamese Ministry of Health, KDIGO guideline 2024, Vietnamese National Drug Formulary 2022, Stanford Health Care Antimicrobial Dosing Reference Guide, and Lexidrug. A logistic regression model was used to identify factors associated with the occurrence of DRP, with p <0.05. Results: A total of 112 medical records of inpatients with CKD were included (mean age 55.27±14.89 years, male 57.1%). The most commonly prescribed medication groups included cardiovascular agents (100.0%), blood and blood – forming organ agents (81.3%), gastrointestinal and metabolic agents (67.0%). Of the total, 41.1% of patients were indicated >8 medications/day and 50.9% of patients stayed in the hospital for ³10 days. The rate of medical records with at least 1 DRP was 83.9%. The majority of DRPs were related to timing of drug administration (31.6%), dosage (31.0%), drug selection (13.9%). Using >8 medications/day (OR=10.408; 95% CI: 1,093 – 99.147; p=0.042) and anti – infectives for systemic use (OR=8.649; 95% CI: 1,704 – 43.916; p=0.009) were associated with increased likelihood of DRP occurrence. Conclusions: The prevalence of DRP in hospitalized patients with CKD was relatively high. Further research is needed to evaluate the clinical relevance of DRP, and appropriate interventions should be implemented to minimize or prevent DRP occurrence in hospitalized patients with CKD, particularly those receiving polypharmacy or anti – infective for systemic use.