Palestinian Medical and Pharmaceutical Journal (Pal. Med. Pharm. J.)

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Palestinian Medical and Pharmaceutical Journal (Pal. Med. Pharm. J.) Indexed in Scopus since 2022
CiteScore 1.0
Indexed since 2022
First decision 7 Days
Submission to acceptance 45 Days
Acceptance to publication 14 Days
Acceptance rate 8%

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Original full research article

Evaluation of Compliance to Treatment Guidelines and Goals of Therapy among Palestinian Hemodialysis Patients

Published
2016-09-20
Pages
15 - 24
Full text

Keywords

  • Palestine
  • Hemodialysis
  • Compliance
  • Kidney
  • Guidelines

Abstract

Patients on hemodialysis usually need management of diabetes, hypertension, dyslipidemia, anemia, and bone mineral disorder. This study was conducted to asses prescribing pattern, to evaluate compliance to treatment guidelines and goals of therapy in hemodialysis patients. This study was an observational retrospective cohort study; it was conducted at Hebron governmental hospital / Palestine. All adult patients on chronic hemodialysis were included. All information were collected from governmental electronic health record (AviCenna HIS program), and patients were asked to answer some questions. During the study period 158 patients were prescribed 1567 medication orders with a mean of 9.92±2.94. The majority of the patients (72.2%) had Hypertension. The target predialysis blood pressure was achieved in 77.2% of the patients (70.5% of the males vs 87.3% of the females; P- value =0.014), and post dialysis blood pressure was achieved in 57.6% cases. Diabetes was a comorbid disease in 36.7% patients and hemoglobin A1c (HbA1c) test was not performed for these patients. Patients with total cholesterol levels of < 200 mg/dl were 78.3% patients. Regarding triglycerides levels, 96.2% had levels of < 500 mg/dl. In the management of anemia, patients who reached goal hemoglobin (Hb) of 11-12 mg/dl according to the national kidney foundation (NKF) guidelines were 8.9% patients only. If kidney disease improving global outcome (KDIGO) guidelines are used (Hb 9-11.5 mg/dl) the patients in this range were 43.0% cases. Transferrin levels were not measured. Iron was used by 69.9% of the patients, and erythropoietin stimulating agents (ESA) by 5.1% of the patients as it was not available in the hospital. No data was available for calcium, and parathyroid hormone levels. Target phosphorus level was obtained in 12.0% of the patients according to the NKF guidelines. If serum phosphorus normal range of 2.5–4.5 mg/dl is used according to KDIGO guidelines, this target was achieved in 4.4% patients only. The results reflect a poor compliance to treatment guidelines. The target levels for treatment are not achieved in many HD patients. The medications are not prescribed optimally to the patients and many investigations and laboratory tests are not performed

Article history

Received
2016-06-05
Accepted
2016-09-20
بحث أصيل كامل

Evaluation of Compliance to Treatment Guidelines and Goals of Therapy among Palestinian Hemodialysis Patients

Published
2016-09-20
الصفحات
15 - 24
البحث كاملا

الكلمات الإفتتاحية

  • Palestine
  • Hemodialysis
  • Compliance
  • Kidney
  • Guidelines

الملخص

Patients on hemodialysis usually need management of diabetes, hypertension, dyslipidemia, anemia, and bone mineral disorder. This study was conducted to asses prescribing pattern, to evaluate compliance to treatment guidelines and goals of therapy in hemodialysis patients. This study was an observational retrospective cohort study; it was conducted at Hebron governmental hospital / Palestine. All adult patients on chronic hemodialysis were included. All information were collected from governmental electronic health record (AviCenna HIS program), and patients were asked to answer some questions. During the study period 158 patients were prescribed 1567 medication orders with a mean of 9.92±2.94. The majority of the patients (72.2%) had Hypertension. The target predialysis blood pressure was achieved in 77.2% of the patients (70.5% of the males vs 87.3% of the females; P- value =0.014), and post dialysis blood pressure was achieved in 57.6% cases. Diabetes was a comorbid disease in 36.7% patients and hemoglobin A1c (HbA1c) test was not performed for these patients. Patients with total cholesterol levels of < 200 mg/dl were 78.3% patients. Regarding triglycerides levels, 96.2% had levels of < 500 mg/dl. In the management of anemia, patients who reached goal hemoglobin (Hb) of 11-12 mg/dl according to the national kidney foundation (NKF) guidelines were 8.9% patients only. If kidney disease improving global outcome (KDIGO) guidelines are used (Hb 9-11.5 mg/dl) the patients in this range were 43.0% cases. Transferrin levels were not measured. Iron was used by 69.9% of the patients, and erythropoietin stimulating agents (ESA) by 5.1% of the patients as it was not available in the hospital. No data was available for calcium, and parathyroid hormone levels. Target phosphorus level was obtained in 12.0% of the patients according to the NKF guidelines. If serum phosphorus normal range of 2.5–4.5 mg/dl is used according to KDIGO guidelines, this target was achieved in 4.4% patients only. The results reflect a poor compliance to treatment guidelines. The target levels for treatment are not achieved in many HD patients. The medications are not prescribed optimally to the patients and many investigations and laboratory tests are not performed

Article history

تاريخ التسليم
2016-06-05
تاريخ القبول
2016-09-20