Assessment of Drug-Related Problems Among Haemodialysis Patients: A Multicentre Prospective Study in Pakistan

Background: Chronic kidney disease constitutes a major burden on healthcare and has become a major global health issue. Haemodialysis patients receive complicated drug therapy with multiple medications, which necessitates the regular monitoring of drug-related problems (DRPs) among renally compromised patients. Method: A prospective cross-sectional study was undertaken in the Haemodialysis Centre of the Divisional Headquarter Hospital, Mirpur and the District Headquarter Hospital, Kotli, Azad Kashmir. All drug-related issues, including drug interactions (DIs), adverse effects, therapeutic failure, overdosage, subtherapeutic dosage, improper drug selection, indication without drug and drug without indication, were evaluated. The association of demographic and clinical variables with DRPs was assessed through univariable logistic regression. Results: 76.7% of patients were observed to have DRPs during haemodialysis. A total of 228 DRPs were identified in 150 patients, including DIs (73/150 patients, 48.7%), adverse drug reactions (ADRs) (68/150 patients, 45.3%), and failure to receive the drug (50/150 patients, 33.3%). Phosphate binders were the largest source of DRPs, while antihypertensive medicines and PPIs/antacids were the second and third most common causes of DRPs, respectively, in haemodialysis patients. The polypharmacy and comorbid conditions were significantly associated (p value <0.05) with increased odds of DRPs in haemodialysis patients. Conclusion: The study identified numerous DRPs in patients undergoing haemodialysis, including DIs, ADRs, and treatment failure. Polypharmacy and comorbidity were found to have significant associations with DRP occurrence.