Preventing acute kidney injury: assessing awareness to temporarily discontinue 'at-risk' medicines during acute illness in a New Zealand cohort

N Z Med J. 2020 Jul 31;133(1519):12-23.

Abstract

Aim: The objective of this research is to determine community dwelling patients' awareness of temporarily discontinuing medicines during acute illness, and the actions they would undertake when acutely unwell.

Method: Adults taking long-term oral medicines for chronic health conditions completed a four-question self-completion paper-based questionnaire collecting data requiring quantitative analysis. Recruitment occurred in six participating Hawke's Bay community pharmacies during 2017 and 2018.

Results: One hundred and thirty people completed the survey. Seventeen (13%) recalled receiving guidance from a health professional on which medicines to stop during excessive vomiting or diarrhoea. Only three people, however, would stop their medicines. Eighteen percent (17/95) of participants aged 65 years and older were prescribed both a NSAID and either an angiotensin-converting-enzyme inhibitor (ACEi) or angiotensin-II receptor blocker (ARB); five reported receiving advice to withhold medicines. Three participants were prescribed a Triple Whammy combination; none reported being advised to withhold medicines.

Conclusion: A small proportion of the participants recalled receiving guidance to temporarily withhold medicines during acute illness; many indicated the advice would not be followed. The results indicate a degree of acute kidney injury prior (AKI) at-risk prescribing. There are opportunities to empower people to self-manage at-risk medicines during periods of acute illness.

MeSH terms

  • Acute Disease*
  • Acute Kidney Injury / chemically induced
  • Acute Kidney Injury / prevention & control*
  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • New Zealand
  • Patient Education as Topic / statistics & numerical data*
  • Prescription Drugs / adverse effects*
  • Risk Factors

Substances

  • Prescription Drugs