Adults with ESKD on hemodialysis may face medication complexity after discharge
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Key takeaways:
- Patients had a higher post- vs. pre-hospitalization medication regimen complexity index.
- Total medication complexity was driven by an increased number of prescriptions.
SAN DIEGO — Adults with end-stage kidney disease on long-term hemodialysis may be confronted with complex medication regimens after hospitalizations, data presented at ASN Kidney Week show.
Patients with ESKD “are probably one of the populations that is the biggest, most complicated [and often] have the most medications,” Sharmilee Vuyyuru, MO, of the University of California Davis in Sacramento, California, told Healio. “We were interested [to know] ... does it cause readmissions? Does it lead to more mortality? These are big questions, and we [wanted to] explore this in our patient population.”
Researchers evaluated data from 80 randomly selected patients with ESKD on hemodialysis at a large university teaching hospital from 2020 to 2024. The goal of the retrospective study was to assess changes in the medication regimen complexity index and patients’ number of prescribed medications before and after hospitalization.
Mean age of patients was 63 years. They had a median dialysis duration of 5 years and median hospital stay of 10 days. They were not discharged to hospice or palliative care.
In addition to demographic and clinical data, researchers collected admission diagnosis, number of prescriptions and medication complexity pre- and post-hospitalization data.
Results showed a significantly higher medication regimen complexity index, which increased from 48.7 to 52.7 after vs. before hospitalization. Total medication complexity was driven by an increased number of prescriptions and higher average prescription complexity, according to Vuyyuru and colleagues. There was no relationship between pre-hospital medication complexity and age, dialysis duration or reason for admission.
Longer hospital stays were linked to higher medication complexity on discharge.
Future research “ideally would head in a way of coming up with a conclusion that is solid to say that this medication regimen complexity index increase is causing, possibly, worse outcomes,” Vuyyuru said.
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Vuyyuru S, et al. FR-PO429. Presented at: ASN Kidney Week; Oct. 24-27, 2024; San Diego.
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