5PSQ-005 Evaluating renal drug dosing appropriateness in patients with reduced glomerular filtration rate: a consensus across multiple drug information sources

<h3>Background and Importance</h3> Various drug information sources provide recommendations for adjusting medication dosing in patients with reduced glomerular filtration rate (GFR). Discrepancies in these recommendations can lead to varying prevalence of inappropriate prescribing or suboptimal patient care. <h3>Aim and Objectives</h3> This study aims to assess the prevalence of inappropriate renal drug dosing and the use of contraindicated medications in patients with reduced GFR, based on a consensus from multiple drug information sources. Additionally, it aimed to identify medications most frequently subject to inappropriate renal dosing adjustments and contraindication. <h3>Material and Methods</h3> This cross-sectional study focused on chronic kidney disease patients admitted to University Hospital Hradec Králové, with an estimated GFR below 60 ml/min. The requirement for renal dose adjustment or contraindication was determined based on the consensus between the Summary of Product Characteristics and other drug information sources – Renal Drug Handbook, British National Formulary, Lexicomp and Micromedex. For medications requiring renal dosing adjustment agreement between the prescribed and recommended renal dosing was assessed. The data were obtained from our previous studies.^{1 2} <h3>Results</h3> Of 375 chronic kidney disease patients, 67 (18%, 95% CI 14–22) received drug dosages that were inconsistent with recommended renal dosing adjustments. Fenofibrate and metformin represented the medication most frequently dosed inappropriately. The prevalence of patients prescribed at least one contraindicated medication was 4%, with fenofibrate, metformin, dabigatran etexilate, ibandronate and nitrofurantoin being the most common. <h3>Conclusion and Relevance</h3> Nearly 1 in 5 patients with reduced GFR received medication dosages that did not align with recommended renal dosing according to the consensus between the Summary of Product Characteristics and other drug information sources. Special attention is required when prescribing metformin and dabigatran etexilate to patients with reduced GFR due to the risks of lactic acidosis and bleeding. <h3>References and/or Acknowledgements</h3> Očovská Z, MaŘíková M, Kočí J, Vlček J. Drug related hospital admissions via the department of emergency medicine: a cross-sectional study from the czech republic. <i>Front Pharmacol</i>. 2022;<b>13</b>:899151. doi: 10.3389/fphar.2022.899151 Očovská Z, Procházková J, MaŘíková M, Vlček J. Renal drug dosage adjustments and adverse drug events in patients with chronic kidney disease admitted to the hospital: a cross-sectional study. <i>Expert Opin Drug Saf</i>. 2024;<b>23</b>(4):457–467. doi: 10.1080/14740338.2023.2295980 <h3>Conflict of Interest</h3> No conflict of interest