Quantifying home medication regimen changes and quality of life in patients receiving nocturnal home hemodialysis
Quantifying home medication regimen changes and quality of life in patients receiving nocturnal home hemodialysis
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DOI：
10.1111/j.1542-4758.2011.00539.x
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发表时间：
2011-04-01
影响因子：
1.3
通讯作者：
Bailie, George R.
中科院分区：
文献类型：
--
作者：
Cardone, Katie E.;Manley, Harold J.;Bailie, George R.
药物治疗方案的简化可以提高终末期肾病患者的依从性。夜间家庭血液透析（NHHD）对药物负担的影响尚不清楚。对NHHD患者进行了回顾性初步研究。在基线、NHHD开始以及3、6、12、18和24个月时收集药物信息。在基线、6、12和24个月时收集SF-36评分。确定了药物的数量、药丸负担和每天的给药次数。在每个时间点使用给药方案复杂性指数作为比较。分析了贫血、矿物质和骨骼疾病（MBD）、心血管（CV）疾病、感染和维生素的药物数量和药丸负担。共纳入35例患者。患者在基线时使用10.5 +/- 4.4种药物，在研究结束时使用11.8 +/- 4.7种药物（P=NS）。关于药物数量，研究结束时，贫血药物、抗感染药物和维生素增加; MBD和CV药物减少。总药丸负担在24个月内没有变化，贫血药丸负担也没有变化。矿物质骨疾病和CV药丸负担减少，维生素和抗感染药丸负担增加。24个月时，每日给药次数从5.0 +/- 1.5显著降低至3.6 +/- 1.5。转换为NHHD与24个月时药物治疗方案复杂性指数显著增加相关（P < 0.05）。一旦患者开始NHHD，SF-36评分显著增加。药物治疗方案复杂性与SF-36评分无相关性。开始NHHD后，药物负担随时间变化。目前尚不清楚NHHD对依从性或药物费用的影响，需要在前瞻性比较研究中进行进一步研究。
Medication regimen simplification may improve adherence in end-stage kidney disease. The effect of nocturnal home hemodialysis (NHHD) on medication burden is unknown. A retrospective pilot study of NHHD patients was conducted. Medication information was collected at baseline, NHHD start, and at 3, 6, 12, 18, and 24 months. SF-36 scores were collected at baseline, 6, 12, and 24 months. The number of medications, pill burden, and number of administrations per day were determined. Medication Regimen Complexity Index was used at each time point as a comparator. Medications for anemia, mineral and bone disorders (MBD), cardiovascular (CV) disease, infection, and vitamins were analyzed for number of medications and pill burden. Thirty-five patients were included. Patients used 10.5 +/- 4.4 medications at baseline and 11.8 +/- 4.7 at the end of the study (P=NS). Regarding the number of medications, anemia medications, anti-infectives, and vitamins increased; MBD and CV medications decreased by the end of the study. Total pill burden did not change over 24 months, nor did anemia pill burden. Mineral bone disorder and CV pill burden decreased, and vitamins and anti-infective pill burden increased. Daily medication administration times decreased significantly from 5.0 +/- 1.5 to 3.6 +/- 1.5 by 24 months. Switching to NHHD was associated with a significant increase in Medication Regimen Complexity Index at 24 months (P < 0.05). SF-36 scores increased significantly once patients began on NHHD. No measure of medication regimen complexity was correlated with the SF-36 score. Medication burden changes over time after starting NHHD. It is unknown what effect NHHD has on adherence or medication costs, and warrants further study in a prospective comparative investigation.