What does this research mean for the field?

Dosage-related issues, specifically excessively high or low doses and drug selection errors, are the most prevalent medication therapy problems among hospitalized patients with decreased kidney function, though significant literature gaps exist regarding acute kidney injury and the role of pharmacists. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This scoping review aims to identify medication therapy problems (MTPs) in hospitalized patients with decreased kidney function.

April 1, 2026Open Access

Medication Therapy Problems in Hospitalized Patients with Decreased Kidney Function Across the Spectrum of Kidney Disease: A Scoping Review

Puntos clave

This scoping review aims to identify medication therapy problems (MTPs) in hospitalized patients with decreased kidney function.
Included adult patients with decreased kidney function from various studies.
Conducted literature searches in multiple databases.
Two independent reviewers screened studies and extracted data.
MTPs were re-categorized using PQA and PCNE frameworks.
Identified 23 studies with 7151 patients examining MTPs.
Most common MTP was identified using PCNE framework, particularly 'Drug selection'.
Reclassification revealed 10,596 MTPs, primarily 'Safety—dosage too high' and 'Effectiveness—dosage too low'.
Gaps included variability in MTP definitions and underrepresentation of AKI patients.

Resumen

Background: This scoping review aimed to identify gaps in the literature regarding medication therapy problems (MTPs) among hospitalized adults with decreased kidney function. Specifically, it aimed to answer the following questions: (1) What types of MTPs have been reported? (2) What is the reported prevalence of MTPs? (3) Do MTPs differ by type of kidney disease? (4) What gaps exist regarding MTPs and pharmacists’ involvement? Methods: Studies involving adult patients with decreased kidney function that investigated MTPs were included. Studies focused exclusively on post-transplant care, chemotherapy, or a single MTP type were excluded. Literature searches were conducted in PubMed, EMBASE, Cochrane Library, Web of Science, and International Pharmaceutical Abstracts. Two independent reviewers screened and extracted data, with a third reviewer resolving discrepancies. All identified MTPs were re-categorized using the Pharmacy Quality Alliance (PQA) framework and the Pharmaceutical Care Network Europe (PCNE) classification. Results: A total of 23 studies met the inclusion criteria, including two conference proceedings, encompassing 7151 patients. The most common MTP framework was the PCNE classification (13 studies, 57%). Reclassification using the PQA yielded 10,596 MTPs, most frequently “Safety—dosage too high” (n = 2464) and “Effectiveness—dosage too low” (n = 2262). Reclassification using the PCNE yielded 11,574 MTPs, most frequently “Drug selection” (n = 6974) and “Dose selection” (n = 2636). All studies involved patients with chronic kidney disease (CKD), and two also included acute kidney injury (AKI). Conclusions: Dosage-related MTPs were most prevalent among hospitalized patients with decreased kidney function. Variability in MTP definitions, limited representation of patients with AKI and AKD, and minimal reporting on pharmacists’ roles reveal important gaps. Addressing these gaps through standardized MTP classification and further research in understudied kidney disease populations may enhance patient safety and support clinical pharmacists’ contributions to optimizing medication safety across the kidney disease continuum.

Leer artículo completoexternamente

Preguntar a la IA

Me gusta

Guardar

Ver artículo completo