Drug dosing in patients with impaired renal function has to be handled carefully. It is estimated that in Austria up to 800.000 people are affected by chronic kidney disease (CKD). These patients often suffer from other chronic diseases and take drugs that can be nephrotoxic themselves or their dosage has to be reduced in patients with existing CKD. The goal setting of the diploma thesis was to create a platform for improving drug safety in patients with CKD. Furthermore, the effectiveness of decision support solutions (DSS) was analysed.
Drugs were studied for their potential renal interaction. Based on these results a website displaying dosage recommendations for patients with CKD was designed. This drug safety platform was complemented with a physical patient card. The created prototype platform was rated with an usability survey. A systematic review was conducted to evaluate effectiveness of DSS. Inverse variance with a random effects analysis model and risk ratio as effect measure with a 95% CI were chosen as parameters for the statistical analysis.
The usability of the developed drug safety platform was rated with 82 out of 100 points. Dosage recommendations for 573 drugs were included in the platform. The systematic review showed that DSS are expected to reduce medication errors with an overall risk ratio of 0.24 (CI 95% 0.13 0.43). A wide variance of this positive effect was observed.
The prototype platform provides a solid basis for improving drug safety in patients with CKD. However, there is still potential for improvement and further development. Introduction of a DSS will have a positive effect but the extent of this effect will vary depending on multiple factors.