Abstract: FR-PO428
Profiles of Home Medication Use in Patients on Dialysis Globally
Session Information
- Hemodialysis Epidemiology and Outcomes
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Feuersenger, Astrid, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
- Roth, Luisa, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
- Wolf, Melanie, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
- Arkossy, Otto, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
- Larkin, John W., Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
- Walter, Jan, Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
- Arens, Hans-Juergen, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
Group or Team Name
- Global Medical Office.
Background
Global patterns of medication use in dialysis are undefined. This project aims to provide a real-world view of home medication use in dialysis using a global dialysis dataset from 40 countries called Apollo Dial DB. The most common prescribed medications administered at home by patients were compared by modality.
Methods
Apollo Dial DB includes adult dialysis patient data from a global kidney network during Jan 2018-Mar 2021 (Fresenius Medical Care, Bad Homburg, DE). Data anonymization was performed in alignment with recommendations from a re-identification risk determination (Privacy Analytics, Ontario, CA). Home medications were analyzed based on top (most common) five pharmacological classes defined by first 4-digits of ATC code; classes were stratified by modality.
Results
In Apollo Dial DB 109,888 in-center hemodialysis (HD) patients had 1,459,954 ATC code medication entries (13.3 drugs/patient), 6,466 peritoneal dialysis (PD) patients had 35,873 ATC codes (5.5 drugs/patient), and 1,899 home HD patients 10,228 ATC codes (5.4 drugs/patient). Top pharmacological classes included phosphate binders and antihypertensives for all modalities, yet differences existed by modality (Figure 1).
Conclusion
Home medication use appears 2-fold higher for in-center HD versus PD and home HD. Most common medications included calcium phosphate binders, 50% of in-center, 57% of home HD, and 33% of PD patients. Beta-blockers were commonly used for hypertension management in HD (48% in-center, 37% home patients), while calcium channel blockers were most used in PD (33%). Antithrombotics were more prevalent in HD (48% in-center, 54% home patients) and gastroesophageal medications in home HD patients (33%). Antiemetics and diuretics were more prevalent in PD patients (42% and 33%). Insights provide benchmarks for the community. Further research is needed accounting for duration of use and considering real-world application of various drugs (e.g., GLP1 drugs, HIF-PH inhibitors).