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Medication Burden and Regimen Complexity Among Dialysis Patients from 2003 to 2024
Harold J Manley1, Nien Chen Li1, Scot Born1
1Dialysis Clinic Inc, Nashville, TN.
Summary
Medication burden significantly increased for dialysis patients over 22 years. This trend highlights growing polypharmacy and complexity in managing patient prescriptions.
Area of Science:
- Nephrology
- Clinical Pharmacy
- Public Health
Background:
- Medication burden is a critical issue for patients undergoing maintenance dialysis.
- Existing studies often lack longitudinal data on medication burden.
- This study examines medication burden trends over two decades in a large dialysis patient cohort.
Purpose of the Study:
- To investigate the longitudinal changes in medication burden among patients receiving maintenance dialysis.
- To characterize trends in medication use, polypharmacy, pill burden, and regimen complexity.
- To identify factors contributing to medication burden in this population.
Main Methods:
- Analysis of data from 82,549 patients on hemodialysis (HD) or peritoneal dialysis (PD) from 2003-2024.
- Medication burden assessed by medication count, polypharmacy (≥10 medications), pill count, and Medication Regimen Complexity Index (MRCI).
- Longitudinal trends analyzed using generalized linear models with generalized estimating equations.
Main Results:
- The average number of medications per patient per day increased from 13.4 to 15.9.
- Polypharmacy prevalence rose from 77% to 87% over the study period.
- Treatments for bone and cardiovascular diseases were major contributors to the increased medication burden.
Conclusions:
- Medication burden has substantially increased in patients on maintenance dialysis over the past two decades.
- This highlights a growing challenge in medication management for this patient group.
- The findings underscore the need for strategies to optimize medication regimens in dialysis patients.
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