eISSN: 2081-2833
ISSN: 2081-0016
Medycyna Paliatywna/Palliative Medicine
Current issue Archive About the journal Abstracting and indexing Subscription Contact Instructions for authors
vol. 9
Original paper

Safe pharmacotherapy of symptoms in patients with end-stage kidney disease – results of a questionnaire performed on physicians working in palliative care units

Aleksandra Kotlińska-Lemieszek, Ewa Deskur-Śmielecka

Online publish date: 2018/02/01
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
Introduction: Palliative care specialists are more commonly involved in the care of patients with renal insufficiency.

The aim of the study: Evaluate the knowledge of physicians working in palliative care about prescribing essential drugs used for symptom control in patients with end-stage kidney disease.

Material and methods: Physicians working in palliative care were asked to fill in a questionnaire on prescribing 40 essential drugs used for symptom control in patients with end-stage kidney disease (GFR < 15 ml/min/1.73 m2).

Results: The questionnaire was filled in by 65 physicians. The percentage of correct answers to all questions equalled 36.9–81.5. The respondents showed the best knowledge of the principles of using analgesics. The most erroneous responses concerned antiepileptics, mirtazapine, venlafaxine, ibandronic acid, and baclofen. In the case of 13.8–58.3% of answers, drugs that should be avoided if possible in patients with significant renal impairment were erroneously classified as safe or to be used cautiously in reduced doses, which concerned non-steroidal anti-inflammatory drugs, diazepam, phenytoin, mirtazapine, duloxetine, venlafaxine, risperidone, phenobarbital, bisphosphonates, and baclofen. Based on the literature, the basic recommendations for the correct prescribing of medicines used to relieve symptoms in patients with impaired renal function are presented the discussion.

Conclusions: The presented study indicates insufficient level of knowledge among palliative care physicians about the choice and dosage of medicines used to relieve symptoms in patients with end-stage kidney disease, and the need to develop recommendations on this topic.

drug therapy, palliative care, renal insufficiency

Dogan E, Izmirli M, Ceylan K i wsp. Incidence of renal insufficiency in cancer patients. Adv Ther 2005; 22: 357-362.
Launay-Vacher V, Oudard S, Janus N i wsp. Prevalence of renal insufficiency in cancer patients and implications for anticancer drug management. Cancer 2007; 110: 1376-1384.
Janus N, Launay-Vacher V, Byloos E i wsp. Cancer and renal insufficiency of the BIRMA study. Br J Cancer 2010; 103: 1815-1821.
Deskur-Smielecka E, Kotlinska-Lemieszek A, Niemir Z, Wieczorowska-Tobis K. Prevalence of renal impairment in palliative care inpatients: a retrospective analysis. J Palliat Med 2015; 18: 613-617.
McEvoy GK. American Hospital Formulary Service, Maryland, USA: American Society of Health-System Pharmacists. www.medicinescomplete.com.
Sweetman SC. Martindale: The Complete Drug Reference. London: Pharmaceutical Press.
Brown EA, Murtagh EM, Murphy E. Kidney disease from advanced disease to bereavement. Wyd. 2. Oxford University Press, Oksford 2012.
The Renal Drug Handbook: The Ultimate Prescribing. Guide for Renal Practitioners. Wyd. 4. Pod redakcją C Ashely i A Dunleavy. Radcliffe Publishing, London 2014.
Summary of Product Characteristics (UK). Dostępne na: www.medicines.org.uk/emc.
Wilcock A, Charlesworth S, Twycross R i wsp. Prescribing Non-Opioid Drugs in End-Stage Kidney Disease. J Pain Symptom Manage 2017; 54: 776-787.
Geng CJ, Liang Q, Zhong JH i wsp. Ibandronate to treat skeletal-related events and bone pain in metastatic bone disease or multiple myeloma: a meta-analysis of randomised clinical trials. BMJ Open 2015; 5: 1-10.
Quick links
© 2019 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe