Structured medication review, patient education, interprofessional coordination, and ongoing monitoring are central nursing strategies for safely managing polypharmacy in cardio-renal disease.
What nursing strategies are effective for addressing polypharmacy and medication safety in patients with cardio-renal disease?
Structured nursing strategies, including medication reconciliation, patient education, and interprofessional collaboration, are essential for mitigating the risks of polypharmacy in cardio-renal disease.
Abstract Introduction Patients with cardio-renal disease often live with multi morbidity and complex medication regimens. Polypharmacy is common. While cardiovascular and renal therapies are essential for improving outcomes, their combination increases treatment burden and the risk of medication-related harm. For nurses, managing medication safety at the intersection of cardiovascular and renal therapies is a daily clinical challenge. Purpose This integrative review synthesized the literature on nursing strategies addressing polypharmacy and medication safety in cardio-renal disease, where cardiovascular and renal therapies intersect. Methods An integrative literature review was conducted following the Whittemore and Knafl framework. The structured literature search was carried out in Pubmed and CINAHL, including empirical studies, reviews, consensus statements and practice-oriented publications addressing polypharmacy, medication safety and nursing or multidisciplinary care in cardio-renal populations. Thematic synthesis was used for the included literature analysis. Results The integrative synthesis emphasized nursing-led and nursing- relevant strategies across both english and german language literature. Four key nursing strategies were identified. First, structure medication review and reconciliation, particularly during transitions of care, were consistently described as essential to reducing medication discrepancies and inappropriate prescribing. Second, patient education and support of self- management played a central role in improving medication understanding, adherence and safety. Third, interprofessional coordination between nursing, cardiology, nephrology and pharmacy was critical for balancing guideline-directed therapy with the avoidance of inappropriate polypharmacy. Finally, ongoing monitoring and early identification of medication- related problems were highlighted as core nursing responsibilities, especially in the context of declining renal function and progressive heart failure. Across the literature, polypharmacy was consistently associated with increased adverse drug reactions, drug-drug interactions, hospitalisation risk and reduced quality of life. Conclusion Nursing strategies are central to the safe management of polypharmacy in cardio-renal disease. Structured medication management, patient-centred education and interprofessional collaboration support medication safety at the intersection of cardiovascular and renal care. Strengthening advanced nursing roles in medication management may help reduce treatment burden and improve outcomes in this complex patient population.
Rizou et al. (Wed,) conducted a review in Cardio-renal disease. Nursing strategies was evaluated on Medication safety and polypharmacy management. Structured medication review, patient education, interprofessional coordination, and ongoing monitoring are central nursing strategies for safely managing polypharmacy in cardio-renal disease.