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Potentially inappropriate medications in older kidney transplant recipients: a Brazilian prevalence study

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Abstract

Background Older kidney transplant recipients take a larger number of medications than younger patients, but there is currently no evidence that this affects health outcomes or that is it associated with potentia medicine-related problems. Objective To evaluate the prevalence and number of potentially inappropriate medications in older kidney transplant recipients and also the possible associated factors (sex, age, comorbidities, number of medications, etc.). Setting A renal post-transplant ambulatory outpatient clinic of a university hospital in Fortaleza, Brazil. Method PIMs were defined according to the Beers criteria, version 2015. Medications were classified following the Anatomical Therapeutic Chemical Classification System. Chi squared tests and analysis of variance were used for the analyses. Main outcome measure Prevalence of potentially inappropriate medications and medication groups with higher prevalence rates of PIMs, including associated factors. Results Among 143 kidney transplant recipients, 77.6% had at least one potentially inappropriate medication as part of their prescription regime. Medication groups that were most implicated in PIM are medicines that act on the alimentary tract and metabolism (55.9%), cardiovascular system (32.2%) and nervous system (21.7%). We detected a high prevalence (63.6%) of self-medication (use of OTC medicines without indication of a healthcare professional) among the population studied. There was a statistically significant association between the number of prescribed medications and the presence of potentially inappropriate medication in the prescription regime (P < 0.01). Conclusion Our data draw attention to the need of medicine therapy management by clinical pharmacists and clinicians in this group of patients and also assessing the real clinical impacts of these medications in the prescription regimes of elderly renal transplant patients.

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Acknowledgements

The authors are truly grateful to all patients who participated in this study. They also would like to thank all members of the Kidney transplant healthcare team of the University Hospital in Fortaleza, Brazil.

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Authors and Affiliations

  1. Programa de Residência Integrada Multiprofissional em Assistência Hospitalar à saúde, Assistência em Transplantes da Universidade Federal do Ceará, Fortaleza, Brazil

    Iwyson Henrique Fernandes da Costa, Renan Morais e Silva, Juliana de Oliveira Carlos, Maria Cleonice Araújo Silva & Maria Karine Cavalcante Pinheiro

  2. Universidade Federal do Ceará, Fortaleza, Brazil

    Bruna Cristina Cardoso Martins

  3. Serviço de Nefrologia e Transplante Renal do Hospital Universitário Walter Cantídio, Fortaleza, Brazil

    Paula Frassinetti Castelo Branco Camurça Fernandes

  4. Serviço de Farmácia Clínica do Hospital Universitário Walter Cantídio, Fortaleza, Brazil

    Marjorie Moreira Guedes

  5. Hospital Universitário Walter Cantídio, Rua Capitão Francisco Pedro 1290, Rodolfo Teófilo, Fortaleza, Ceará, 60430-372, Brazil

    Iwyson Henrique Fernandes da Costa

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  1. Iwyson Henrique Fernandes da Costa
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  2. Renan Morais e Silva
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  3. Juliana de Oliveira Carlos
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  4. Maria Cleonice Araújo Silva
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  5. Maria Karine Cavalcante Pinheiro
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  6. Bruna Cristina Cardoso Martins
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  7. Paula Frassinetti Castelo Branco Camurça Fernandes
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Correspondence to Iwyson Henrique Fernandes da Costa.

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da Costa, I.H.F., Silva, R.M.e., Carlos, J.d.O. et al. Potentially inappropriate medications in older kidney transplant recipients: a Brazilian prevalence study. Int J Clin Pharm 41, 888–894 (2019). https://doi.org/10.1007/s11096-019-00842-2

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  • DOI: https://doi.org/10.1007/s11096-019-00842-2

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