Prilagodba doza lijekova u osoba na kroničnoj hemodijalizi koje se liječe na Odjelu za dijalizu Kliničke bolnice Dubrava u Zagrebu

Objectives: The aim of this study was to determine the frequency of inappropriate dosing of drugs requiring dose adjustment in patients on chronic hemodialysis and other pharmacotherapeutic problems and the acceptance rate of pharmaceutical interventions by physicians. Patients and methods: The study included patients on intermittent hemodialysis at the Dialysis Department of Clinical hospital Dubrava. Medication history was obtained and a pharmacotherapeutic review was performed by a clinical pharmacist. Drugs for which the dose was not adjusted, the clinical pharmacist addressed the suggested intervention to the nephrologyst. If another pharmacotherapeutic problem is detected during the pharmacotherapeutic review, pharmaceutical intervention is also referred. Interventions were recorded as accepted or unaccepted. Results: The study included 60 patients, of which 38 were men and 22 were women. The mean age of the subjects was 67.0 ± 12.4 years. Patients used 12.2 ± 4.4 drugs, of which 9.9 ± 4.3 at home in 13.6 ± 5.9 doses, and 2.2 ± 0.7 drugs in the dialysis center. 4,2% of 596 prescribed drugs had the unadjusted dose, while 4,5% drugs were contraindicated in hemodialysis population. 55% patients had an unadjusted dose and/or contraindication to the used drug. The acceptance rate of pharmaceutical interventions was 37% in this regard. Pharmaceutical interventions regarding other drug related problems were completely accepted: nonadherence (19), duplication of therapy (9) and drug interactions (11). In total, 64 % of all pharmaceutical interventions were accepted. Conclusion: People undergoing hemodialysis use a large number of drugs, and over half of the subjects had a drug whose dose were unadjusted and/or its use was contraindicated. A large number of pharmaceutical interventions suggest the need to include a clinical pharmacist in a team caring for people on chronic hemodialysis to ensure positive treatment outcomes, while reducing the risk of side effects and increasing patient safety.