开发一份与肾脏相关的药物清单，作为提高慢性肾脏病患者药物优化的工具。
Development of a list with renally relevant drugs as a tool to increase medicines optimisation in patients with chronic kidney disease.
机构信息
Department of Pharmacy, Klinikum Fulda gAG, Fulda, Germany
Faculty of Pharmacy, University of Marburg Institute of Pharmacology and Clinical Pharmacy, Marburg, Germany.
出版信息
Eur J Hosp Pharm. 2023 Jan;30(1):46-52. doi: 10.1136/ejhpharm-2020-002571. Epub 2021 May 13.
OBJECTIVES
Chronic kidney disease (CKD) is a common disorder all over the world. Therapeutic goals are early detection of declining renal function and implementation of adequate pharmacological treatments regarding underlying and secondary diseases. As therapy becomes more complex with increasing stages of CKD, a decision-making tool for healthcare professionals could help to ensure safe drug treatment in patients with CKD in the outpatient setting. Therefore, a list of renally relevant drugs as a decision-making tool was developed to improve medicines optimisation for CKD patients in the outpatient setting long term.
METHODS
A renally relevant drug list (RRD-list) with renally relevant drugs, based on data from a study on medicines optimisation in patients with CKD from June 2015 to March 2018, was developed at the nephrological outpatient clinic at the Klinikum Fulda, Germany. The whole study is published elsewhere. A clinical pharmacist reviewed the patients' medications, current drug-related problems and all nephrologists' recommendations, and categorised all detected drugs into renally relevant and non-renally relevant groups. The 10 most frequently detected renally relevant drug groups were summarised in the RRD-list and extended by treatment alternatives and advice.
RESULTS
The medication of 160 patients, who were receiving overall 1376 drugs, was analysed; 831 drugs were defined as renally relevant. Drug-related problems were caused by 543 renally relevant drugs. The nephrologists made 292 recommendations regarding 28 drug classes. Considering the 10 most frequent drug groups, in total 16 renally relevant drug groups with 36 drug classes were added to the RRD-list.
CONCLUSIONS
The RRD-list could be an essential tool for all healthcare professionals in their daily work, such as general practitioners and community pharmacists, for the treatment of patients with renal insufficiency.
目的
慢性肾脏病（CKD）是一种在全球范围内普遍存在的疾病。治疗目标是早期发现肾功能下降，并针对潜在和继发疾病实施适当的药物治疗。随着 CKD 阶段的增加，治疗变得更加复杂，因此需要为医疗保健专业人员提供一个决策工具，以确保在门诊环境中安全地治疗 CKD 患者。因此，开发了一份与肾脏相关的药物清单（RRD 清单）作为决策工具，以长期改善门诊 CKD 患者的药物优化。
方法
德国富尔达诊所肾病门诊根据 2015 年 6 月至 2018 年 3 月期间一项关于 CKD 患者药物优化的研究数据，制定了一份与肾脏相关的药物清单（RRD 清单）。整个研究已在其他地方发表。一名临床药剂师审查了患者的药物、当前与药物相关的问题以及所有肾病医生的建议，并将所有检测到的药物分为与肾脏相关和非与肾脏相关的药物。RRD 清单中总结了 10 种最常检测到的与肾脏相关的药物组，并扩展了治疗替代方案和建议。
结果
分析了 160 名接受总共 1376 种药物治疗的患者的药物；831 种药物被定义为与肾脏相关。药物相关问题是由 543 种与肾脏相关的药物引起的。肾病医生对 28 个药物类别提出了 292 条建议。考虑到最常见的 10 种药物组，共增加了 16 个与肾脏相关的药物组，共计 36 个药物类别。
结论
RRD 清单对于全科医生和社区药剂师等所有医疗保健专业人员在日常工作中治疗肾功能不全患者来说是一个重要的工具。
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