Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease
IntroductionChronic kidney disease (CKD) is associated with multimorbidity and high treatment burden. Pill-burden is one component of the overall treatment burden. However, little is known about its magnitude and contribution to the overall treatment burden among patients with advanced stages of CKD...
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2023
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| Online Access: | http://dx.doi.org/10.1016/j.jsps.2023.03.008 https://www.sciencedirect.com/science/article/pii/S1319016423000580 http://hdl.handle.net/10576/42324 |
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| _version_ | 1857415086583316480 |
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| author | Asmaa, Al-mansouri |
| author2 | Hamad, Abdullah Ibrahim Al-Ali, Fadwa Saqr Ibrahim, Mohamed Izham Mohamed Kheir, Nadir Al-Ziftawi, Nour Hisham Ibrahim, Rania Abdelaziz AlBakri, Muna Awaisu, Ahmed |
| author2_role | author author author author author author author author |
| author_facet | Asmaa, Al-mansouri Hamad, Abdullah Ibrahim Al-Ali, Fadwa Saqr Ibrahim, Mohamed Izham Mohamed Kheir, Nadir Al-Ziftawi, Nour Hisham Ibrahim, Rania Abdelaziz AlBakri, Muna Awaisu, Ahmed |
| author_role | author |
| dc.creator.none.fl_str_mv | Asmaa, Al-mansouri Hamad, Abdullah Ibrahim Al-Ali, Fadwa Saqr Ibrahim, Mohamed Izham Mohamed Kheir, Nadir Al-Ziftawi, Nour Hisham Ibrahim, Rania Abdelaziz AlBakri, Muna Awaisu, Ahmed |
| dc.date.none.fl_str_mv | 2023-05-04T06:47:56Z 2023-03-18 |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://dx.doi.org/10.1016/j.jsps.2023.03.008 Al-mansouri, A., Hamad, A. I., Al-Ali, F. S., Ibrahim, M. I. M., Kheir, N., Al-Ziftawi, N. H., ... & Awaisu, A. (2023). Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease. Saudi Pharmaceutical Journal. 1319-0164 https://www.sciencedirect.com/science/article/pii/S1319016423000580 http://hdl.handle.net/10576/42324 5 31 2213-7475 |
| dc.language.none.fl_str_mv | en |
| dc.publisher.none.fl_str_mv | Elsevier |
| dc.rights.none.fl_str_mv | http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Treatment burden Medication burden Pill-burden Polypharmacy Chronic kidney disease Hemodialysis |
| dc.title.none.fl_str_mv | Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | IntroductionChronic kidney disease (CKD) is associated with multimorbidity and high treatment burden. Pill-burden is one component of the overall treatment burden. However, little is known about its magnitude and contribution to the overall treatment burden among patients with advanced stages of CKD. This study aimed to quantify the magnitude of pill-burden in dialysis-dependent vs. non-dialysis-dependent advanced-stage CKD patients and its association with treatment burden. MethodsThis was a cross-sectional study for the assessment of pill-burden and treatment burden among non-dialysis and hemodialysis (HD)-dependent CKD patients. Pill-burden was quantified as “number of pills/patient/week” through electronic medical record, while treatment burden was assessed using the “Treatment Burden Questionnaire (TBQ)”. Furthermore, oral and parenteral medication burden was also quantified. Data were analyzed using both descriptive and inferential analysis, including Mann – Whitney U test and two-way between groups analysis of variance (ANOVA). ResultsAmong the 280 patients included in the analysis, the median (IQR) number of prescribed chronic medications was 12 (5.7) oral and 3 (2) parenteral medications. The median (IQR) pill-burden was 112 (55) pills/week. HD patients experienced higher pill-burden than non-dialysis patients [122 (61) vs. 109 (33) pills/week]; however, this difference did not reach statistical significance (p = 0.81). The most commonly prescribed oral medications were vitamin D (90.4%), sevelamer carbonate (65%), cinacalcet (67.5%), and statins (67.1%). Overall, patients who had high pill-burden (≥112 pills/week) had significantly higher perceived treatment burden compared to low pill-burden patients (<112 pills/week) [47(36.2) vs. 38.5(36.7); p = 0.0085]. However, two-way ANOVA showed that dialysis status is the significant contributor to the treatment-burden in the high overall pill-burden group (p < 0.01), the high oral-medication-burden group (p < 0.01), and the high parenteral-medication-burden group (p = 0.004). ConclusionsPatients with advanced CKD experienced a high pill-burden, which increases the treatment burden; however, the dialysis status of the patient is the main factor affecting the overall treatment burden. Future intervention studies should target this population with an aim to reduce polypharmacy, pill-burden, and treatment burden, which may ultimately improve CKD patients’ quality of life. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | qu_5154ca026e01b1f5d184b5770cb37d21 |
| identifier_str_mv | Al-mansouri, A., Hamad, A. I., Al-Ali, F. S., Ibrahim, M. I. M., Kheir, N., Al-Ziftawi, N. H., ... & Awaisu, A. (2023). Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease. Saudi Pharmaceutical Journal. 1319-0164 5 31 2213-7475 |
| language_invalid_str_mv | en |
| network_acronym_str | qu |
| network_name_str | Qatar University repository |
| oai_identifier_str | oai:qspace.qu.edu.qa:10576/42324 |
| publishDate | 2023 |
| publisher.none.fl_str_mv | Elsevier |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| spelling | Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney diseaseAsmaa, Al-mansouriHamad, Abdullah IbrahimAl-Ali, Fadwa SaqrIbrahim, Mohamed Izham MohamedKheir, NadirAl-Ziftawi, Nour HishamIbrahim, Rania AbdelazizAlBakri, MunaAwaisu, AhmedTreatment burdenMedication burdenPill-burdenPolypharmacyChronic kidney diseaseHemodialysisIntroductionChronic kidney disease (CKD) is associated with multimorbidity and high treatment burden. Pill-burden is one component of the overall treatment burden. However, little is known about its magnitude and contribution to the overall treatment burden among patients with advanced stages of CKD. This study aimed to quantify the magnitude of pill-burden in dialysis-dependent vs. non-dialysis-dependent advanced-stage CKD patients and its association with treatment burden. MethodsThis was a cross-sectional study for the assessment of pill-burden and treatment burden among non-dialysis and hemodialysis (HD)-dependent CKD patients. Pill-burden was quantified as “number of pills/patient/week” through electronic medical record, while treatment burden was assessed using the “Treatment Burden Questionnaire (TBQ)”. Furthermore, oral and parenteral medication burden was also quantified. Data were analyzed using both descriptive and inferential analysis, including Mann – Whitney U test and two-way between groups analysis of variance (ANOVA). ResultsAmong the 280 patients included in the analysis, the median (IQR) number of prescribed chronic medications was 12 (5.7) oral and 3 (2) parenteral medications. The median (IQR) pill-burden was 112 (55) pills/week. HD patients experienced higher pill-burden than non-dialysis patients [122 (61) vs. 109 (33) pills/week]; however, this difference did not reach statistical significance (p = 0.81). The most commonly prescribed oral medications were vitamin D (90.4%), sevelamer carbonate (65%), cinacalcet (67.5%), and statins (67.1%). Overall, patients who had high pill-burden (≥112 pills/week) had significantly higher perceived treatment burden compared to low pill-burden patients (<112 pills/week) [47(36.2) vs. 38.5(36.7); p = 0.0085]. However, two-way ANOVA showed that dialysis status is the significant contributor to the treatment-burden in the high overall pill-burden group (p < 0.01), the high oral-medication-burden group (p < 0.01), and the high parenteral-medication-burden group (p = 0.004). ConclusionsPatients with advanced CKD experienced a high pill-burden, which increases the treatment burden; however, the dialysis status of the patient is the main factor affecting the overall treatment burden. Future intervention studies should target this population with an aim to reduce polypharmacy, pill-burden, and treatment burden, which may ultimately improve CKD patients’ quality of life.The study received funding from Qatar University (grant number: QUCG- CPH-22/23-592 and QUST-CPH-SPR/2017-19).Elsevier2023-05-04T06:47:56Z2023-03-18Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://dx.doi.org/10.1016/j.jsps.2023.03.008Al-mansouri, A., Hamad, A. I., Al-Ali, F. S., Ibrahim, M. I. M., Kheir, N., Al-Ziftawi, N. H., ... & Awaisu, A. (2023). Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease. Saudi Pharmaceutical Journal.1319-0164https://www.sciencedirect.com/science/article/pii/S1319016423000580http://hdl.handle.net/10576/423245312213-7475enhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:qspace.qu.edu.qa:10576/423242024-07-23T13:53:05Z |
| spellingShingle | Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease Asmaa, Al-mansouri Treatment burden Medication burden Pill-burden Polypharmacy Chronic kidney disease Hemodialysis |
| status_str | publishedVersion |
| title | Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease |
| title_full | Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease |
| title_fullStr | Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease |
| title_full_unstemmed | Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease |
| title_short | Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease |
| title_sort | Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease |
| topic | Treatment burden Medication burden Pill-burden Polypharmacy Chronic kidney disease Hemodialysis |
| url | http://dx.doi.org/10.1016/j.jsps.2023.03.008 https://www.sciencedirect.com/science/article/pii/S1319016423000580 http://hdl.handle.net/10576/42324 |