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AuthorAl-mansouri, Asmaa
AuthorHamad, Abdullah Ibrahim
AuthorAl-Ali, Fadwa Saqr
AuthorIbrahim, Mohamed Izham Mohamed
AuthorKheir, Nadir
AuthorAl-Ziftawi, Nour Hisham
AuthorIbrahim, Rania Abdelaziz
AuthorAlBakri, Muna
AuthorAwaisu, Ahmed
Available date2023-11-05T06:14:30Z
Publication Date2023
Publication NameSaudi Pharmaceutical Journal
ResourceScopus
ISSN13190164
URIhttp://dx.doi.org/10.1016/j.jsps.2023.03.008
URIhttp://hdl.handle.net/10576/49014
AbstractIntroduction: Chronic kidney disease (CKD) is associated with multimorbidity and high treatment burden. Pill-burden is one component of the overall treatment burden. However, little is known about its magnitude and contribution to the overall treatment burden among patients with advanced stages of CKD. This study aimed to quantify the magnitude of pill-burden in dialysis-dependent vs. non-dialysis-dependent advanced-stage CKD patients and its association with treatment burden. Methods: This was a cross-sectional study for the assessment of pill-burden and treatment burden among non-dialysis and hemodialysis (HD)-dependent CKD patients. Pill-burden was quantified as "number of pills/patient/week" through electronic medical record, while treatment burden was assessed using the "Treatment Burden Questionnaire (TBQ)". Furthermore, oral and parenteral medication burden was also quantified. Data were analyzed using both descriptive and inferential analysis, including Mann - Whitney U test and two-way between groups analysis of variance (ANOVA). Results: Among the 280 patients included in the analysis, the median (IQR) number of prescribed chronic medications was 12 (5.7) oral and 3 (2) parenteral medications. The median (IQR) pill-burden was 112 (55) pills/week. HD patients experienced higher pill-burden than non-dialysis patients [122 (61) vs. 109 (33) pills/week]; however, this difference did not reach statistical significance (p = 0.81). The most commonly prescribed oral medications were vitamin D (90.4%), sevelamer carbonate (65%), cinacalcet (67.5%), and statins (67.1%). Overall, patients who had high pill-burden (≥112 pills/week) had significantly higher perceived treatment burden compared to low pill-burden patients (<112 pills/week) [47(36.2) vs. 38.5(36.7); p = 0.0085]. However, two-way ANOVA showed that dialysis status is the significant contributor to the treatment-burden in the high overall pill-burden group (p < 0.01), the high oral-medication-burden group (p < 0.01), and the high parenteral-medication-burden group (p = 0.004). Conclusions: Patients with advanced CKD experienced a high pill-burden, which increases the treatment burden; however, the dialysis status of the patient is the main factor affecting the overall treatment burden. Future intervention studies should target this population with an aim to reduce polypharmacy, pill-burden, and treatment burden, which may ultimately improve CKD patients' quality of life.
SponsorThe authors would like to acknowledge Qatar University for the funding provided for the study. This manuscript is part of an MSc dissertation submitted to Qatar University and related abstracts were presented and published as part of the 56th European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) Congress, Budapest, Hungary, 13-16 June 2019. The study received funding from Qatar University (grant number: QUCG- CPH-22/23-592 and QUST-CPH-SPR/2017-19). The content of this paper is the sole responsibility of the authors.
Languageen
PublisherElsevier
SubjectChronic kidney disease
Hemodialysis
Medication burden
Pill-burden
Polypharmacy
Treatment burden
TitlePill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease
TypeArticle
Pagination678-686
Issue Number5
Volume Number31
dc.accessType Open Access


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