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Evaluation of Renal Function Testing in Older Australian Veterans Dispensed Medicines that Require Renal Function Monitoring

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Abstract

Introduction

Renal function testing should be performed prior to initiating medicines that require dose adjustment in renal impairment, with ongoing monitoring in continued use, particularly in older people. There is little evidence regarding the extent to which renal function monitoring is performed in older Australians dispensed medicines requiring renal function monitoring.

Objective

The aim of this study was to determine the extent of renal function testing in older people dispensed medicines requiring renal function monitoring.

Methods

A retrospective analysis of administrative claims data from the Australian Government Department of Veterans’ Affairs was conducted for people aged 65 years or older who were dispensed one or more medicines requiring renal function monitoring, from 1 June 2019 to 30 September 2019, to investigate the proportion of people with a claim for a pathology test that included creatinine levels in the 6–12 months before or after dispensing of a medicine requiring renal function monitoring.

Results

There were 100,113 people who were dispensed at least one medicine requiring renal function monitoring during the study period, of whom 15% had a history of renal impairment and 16% had diabetes mellitus. Sixty-one percent had a claim for a test in the prior 6 months; this increased to 80% of participants with a claim for a test in the prior 12 months. The rate of claims for testing was lower in aged care facility residents compared with people living in the community (54% vs 62% in the previous 6 months; p < 0.001), and was higher in people with diabetes (75% vs 58%; p < 0.001), history of renal impairment (91% vs 59%; p < 0.001) or heart failure (77% vs 60%; p < 0.001) compared with those without these conditions.

Conclusion

Medicines that require renal function monitoring are commonly used in older Australians, and while the majority have claims for tests that include renal function, some are missing out.

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Acknowledgements

This research was funded by the Australian Government Department of Veterans’ Affairs as part of the delivery of the Veterans’ MATES programme.

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Authors and Affiliations

  1. Quality Use of Medicines and Pharmacy Research Centre, UniSA: Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia

    Lisa M. Kalisch Ellett,  Gizat M. Kassie, Emmae N. Ramsay, Nicole L. Pratt & Elizabeth E. Roughead

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  1. Lisa M. Kalisch Ellett
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  2. Gizat M. Kassie
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  3. Emmae N. Ramsay
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  4. Nicole L. Pratt
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Corresponding author

Correspondence to Gizat M. Kassie.

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Funding

There was no funding received to conduct this particular study.

Conflict of Interest

Lisa M. Kalisch Ellett, Gizat M. Kassie, Emmae N. Ramsay, Nicole L. Pratt and Elizabeth E. Roughead declare that they have no potential conflicts of interest that might be relevant to the contents of this manuscript.

Ethical Approval

Ethics approval was obtained from the University of South Australia, and the Departments of Defence and Veterans’ Affairs Human Research Ethics Committees.

Author Contributions

LMKE—study design, data analysis and interpretation, drafting of the manuscript. GMK—study design, data interpretation, writing the manuscript, critical revision of the manuscript for important intellectual content. ENR, NLP, EER—study design, data interpretation, critical revision of the manuscript for important intellectual content. All authors read and approved the final version.

Availability of data and material

Unpublished data related to this study can be requested from the corresponding author Dr Gizat Molla Kassie by email (gizat.kassie@unisa.edu.au).

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Kalisch Ellett, .M., Kassie, .M., Ramsay, E.N. et al. Evaluation of Renal Function Testing in Older Australian Veterans Dispensed Medicines that Require Renal Function Monitoring. Drugs Aging 38, 995–1002 (2021). https://doi.org/10.1007/s40266-021-00892-0

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