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- Title
Overdose rate of drugs requiring renal dose adjustment: data analysis of 4 years prescriptions at a tertiary teaching hospital.
- Authors
Sheen, Seung; Choi, Ji; Park, Rae; Kim, Eun; Lee, Young; Kang, Un; Sheen, Seung Soo; Choi, Ji Eun; Park, Rae Woong; Kim, Eun Yub; Lee, Young Ho; Kang, Un Gu
- Abstract
<bold>Objective: </bold>To determine the overdose rate of drugs that require renal dose adjustment and factors related with overdose.<bold>Subjects: </bold>Total of 23,635,210 records of prescriptions and laboratory data of inpatients at a tertiary teaching hospital for the period from January 2002 to December 2005.<bold>Methods: </bold>A clinical data mart was constructed. A knowledge base containing dose adjusting information about 56 drugs was built. One day dose was compared to the reference dose adjusted to the patient's renal function.<bold>Results: </bold>Considering the patient's renal function, 5.3% of drug doses were excessive. The overdose rate in the patients with moderate to severe renal insufficiency was 28.2%. Only 25% of physicians were responsible for 50.6% of the overdoses. Of 56 drugs studied, 10 drugs, including ranitidine, amoxicillin, and piperacillin/tazobactam, were involved in 85.4% of the overdoses. The physicians with high overdose rate had patients with more impaired renal function (correlation coefficient = 0.192, P < .001). There were negative correlation between clinical experiences of physician and overdose rate (correlation coefficient = -0.221, P < .001) and workload of prescription (correlation coefficient = -0.446, P < .001), when excluding interns from the analyses. There was positive correlation between workload of prescription and overdose rate (correlation coefficient = 0.361, P < .001).<bold>Conclusion: </bold>A clinical data mart was useful to analyze the vast amount of electronic hospital data. Drug overdose is quite common among inpatients with renal insufficiency. Only a few drugs are responsible for most of drug overdoses. The physicians' clinical experience, workload of prescriptions, and patients' renal function are correlated with drug overdose.
- Subjects
DRUG overdose; DRUG abuse; MEDICATION abuse; CHRONIC kidney failure; TEACHING hospitals; MEDICAL education
- Publication
JGIM: Journal of General Internal Medicine, 2008, Vol 23, Issue 4, p423
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-007-0336-8