Assessment of Drug Therapy Problems in Patients with Chronic Kidney Disease at a Dialysis Centre in Lagos

Patients with chronic kidney disease require careful pharmacotherapy management due to altered drug pharmacokinetics and heightened susceptibility to drug-related problems. This study assessed drug therapy problems in patients with chronic kidney disease undergoing dialysis at a renal unit at a tertiary hospital in Lagos, South West Nigeria. A prospective observational study was conducted over five months, with pharmacist-led medication reviews for 96 CKD patients on haemodialysis. Drug therapy problems were identified and classified using the Cipolle, Strand, and Morley classification framework. Renal dose adjustment requirements were assessed using the Renal Drug Handbook and Micromedex. Results identified at least one drug therapy problem in 87.5 percent of patients reviewed, with a mean of 2.6 drug therapy problems per patient. Unnecessary drug therapy was the most prevalent category (24.7 percent of all problems), followed by need for additional drug therapy (22.1 percent) and dosage too high (19.5 percent). Drugs requiring dose adjustment for renal impairment that had not been adjusted included antibiotics, antihypertensives, and analgesics. Pharmacist recommendations were accepted in 81.3 percent of cases. The study concludes that drug therapy problems are highly prevalent among dialysis patients in Lagos, and recommends mandatory clinical pharmacist involvement in renal unit multidisciplinary teams across Nigerian tertiary hospitals to improve pharmacotherapy outcomes.

Keywords: drug therapy problems, chronic kidney disease, haemodialysis, Lagos, clinical pharmacy