Medication-related problems among adult chronic kidney disease patients in a sub-Saharan tertiary hospital.

Background: Chronic kidney disease (CKD) patients are prone to medication-related problems (MRPs). Few studies address the clinical relevance of MRPs among CKD patients in sub-Saharan Africa.
Objective: To investigate the frequency and predictors of MRPs among adult CKD patients treated at a tertiary care facility in an urban sub-Saharan setting.
Setting: Kenyatta National Hospital in Nairobi, Kenya.
Method: A cross-sectional study involving 60 adult patients with CKD was carried out. Data were collected through structured interviews and patient chart reviews between April 2016 and June 2016. MRPs identified from the collected data were classified according to Hepler and Strand classification. The frequencies of the identified MRPs were computed and logistic regression used to investigate the associations between the MRPs and covariates in the data.
Main Outcome Measures: frequencies and predictors of MRPs.
Results: 271 MRPs were identified. The commonest MRPs were drug interactions (21.8%), indication without drug (18.1%) and medication non-adherence (15.5%). Compared to patients with CKD stage 3, patients with CKD stage 4 were 5.9 times more likely to have an improper drug selection and 4.7 times more likely to experience overdosage. Other significant predictors of MRPs were the number of medications per prescription and the number of comorbidities per patient.
Conclusion: This study found a high frequency of MRPs among patients with chronic kidney disease receiving care in urban sub-Saharan tertiary hospital settings. The predictors of MRPs among CKD patients in this setting are likely to be multifactorial and include the CKD stage, polypharmacy, and comorbidities.