Abstract: FR-PO430
Effectiveness of a Multidisciplinary Team Delivered Deprescribing Intervention for Patients with CKD in Qatar: A Preliminary Analysis
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
- Zidan, Amani, Qatar University, Doha, Qatar
- Hamad, Abdullah Ibrahim, Hamad Medical Corporation, Doha, Qatar
- Al-Malki, Hassan A., Hamad Medical Corporation, Doha, Qatar
- Alkadi, Mohamad M., Hamad Medical Corporation, Doha, Qatar
- Elesnawi, Mohamed Amin, Hamad Medical Corporation, Doha, Qatar
- Ibrahim, Rania Abdelaziz, Hamad Medical Corporation, Doha, Qatar
- Al-Badriyeh, Daoud, Qatar University, Doha, Qatar
- Hadi, Muhammad Abdul, Qatar University, Doha, Qatar
- Awaisu, Ahmed, Qatar University, Doha, Qatar
Background
Patients with chronic kidney disease (CKD), especially those receiving hemodialysis (HD), often experience negative consequences related to inappropriate polypharmacy. These can be averted by deprescribing. We aimed to design and assess the impact of a multidisciplinary team-delivered deprescribing intervention for patients receiving hemodialysis in Qatar.
Methods
This study is a randomized, parallel-group, controlled trial (RCT). Adults receiving chronic HD at Qatar's largest ambulatory dialysis center who can communicate in English or Arabic are included. Participants are randomized into the control (usual ambulatory care) or intervention (standardized deprescribing) groups. Intervention patients receive a structured deprescribing intervention using a developed evidence-based guideline. Outcome measures are collected at baseline and six months for all study participants. The primary outcome is the percentage of patients with ≥ 1 potentially inappropriate medication (PIM). The secondary outcomes include pill burden and self-reported adherence (assessed by Adherence to Refills and Medications Scale). A total of 424 patients is needed to reduce the percentage of patients with ≥ 1 PIM by 50%, with an expected attrition rate of 50%.
Results
The study has been ongoing since 19 February 2024. Thirty-seven patients with an average (SD) age of 52.8 (14.6) have been recruited. At baseline, a mean of 1.7 (1.3) PIMs was identified. 83.7% of the patients had at least one PIM prescribed (78.9% control and 88.8% intervention). On average, the participants were taking 132.3 pills per week (131.7 in control and 132.3 in intervention). ARMS mean score was 17.03 (6.12) (control 16.33 (5.16), Intervention 17.76 (7.08)). Twenty-four deprescribing plans have been suggested for 15 patients in the intervention group. Among these, 16 were successfully implemented, 4 were rejected by the physicians, 2 were refused by the patient, and 2 were stopped due to recurrent symptoms.
Conclusion
Our structured deprescribing intervention is promising to improve dialysis patients' health outcomes. With the potential to reduce inappropriate polypharmacy and pill burden, we anticipate a positive impact on patient well-being.
Funding
- Government Support – Non-U.S.