5PSQ-153 An evaluation of adherence to hyperkalaemia guidelines with a revised sodium polystyrene sulfonate dosing

<h3>Background and Importance</h3> Using commonly recommended dosing regimens for sodium polystyrene sulfonate (SPS) has led to the overcorrection of hyperkalaemia in our patients. To mitigate this risk, a Drug Use Evaluation (DUE) was conducted and a reduction in SPS doses was recommended. The revised dosing was incorporated into the hospital’s hyperkalaemia management guidelines. <h3>Aim and Objectives</h3> To ensure patient safety, an audit was performed to evaluate compliance and safety of the revised SPS dosing regimen as well as compliance with the hyperkalaemia guideline. <h3>Material and Methods</h3> One year after implementing the hyperkalaemia guideline, a retrospective audit on prescribing adherence to revised SPS dosing regimen as well as hyperkalaemia guidelines was conducted from March 2023 to March 2024 in the inpatient and outpatient setting of a tertiary institution. The safety of SPS was assessed based on hypokalaemia episodes. <h3>Results</h3> A total of 267 cases were examined, 129 (48.3%) cases were non-adherent to the revised SPS dosing regimen. Factors such as absence of follow-up potassium levels and initiation of SPS despite normokalaemia contributed to 165 cases (61.7%) that deviated from the overall hyperkalaemia guidelines. Fifty-six out of 267 patients were excluded from the safety analysis due to lack of follow-up potassium levels, multiple hyperkalaemic episodes within the same visit, omission of SPS despite being prescribed and initiation of SPS despite normokalaemia. Hypokalaemia was more common in non-compliant cases. Incidence of hypokalaemia in the inpatient settings was 1 out of 66 (1.51%) for compliant cases and 3 out of 34 (8.82%) for non-compliant cases. In the outpatient setting, the incidence of hypokalaemia was 2 out of 35 (5.71%) for compliant cases and 15 out of 76 (19.73%) for non-compliant cases. <h3>Conclusion and Relevance</h3> The audit demonstrated that the revised SPS dosing regimen is safer. Emphasising adherence to these updated dosing guidelines is essential for enhancing patient safety among physicians. Timely reminders and educational resources on the proper use of SPS should be provided. Refining existing prescribing order sets may also support compliance with the updated SPS dosing regimen. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest