Awareness and Knowledge among Internal Medicine House-staff for Dose adjustment of Commonly Used Medications in Patients with CKD

Authors

Sikander Surana, Nassau University Medical Center
Neeru Kumar, Nassau University Medical Center
Amita Vasudeva, Nassau University Medical Center
Gulvahid Shaikh, Nassau University Medical Center
Kenar D. Jhaveri, North Shore University Hospital
Hitesh Shah, North Shore University Hospital
Deepa Malieckal, North Shore University Hospital
Joshua Fogel, CUNY Brooklyn CollegeFollow
Gurwinder Sidhu, Nassau University Medical Center
Sofia Rubinstein, Nassau University Medical Center

Document Type

Article

Publication Date

1-17-2017

Abstract

Background: Drug dosing errors result in adverse patient outcomes and are more common in patients with chronic kidney disease (CKD). As internists treat the majority of patients with CKD, we study if Internal Medicine house-staff have awareness and knowledge about the correct dosage of commonly used medications for those with CKD. Methods: A cross-sectional survey was performed and included 341 participants. The outcomes were the awareness of whether a medication needs dose adjustment in patients with CKD and whether there was knowledge for the level of glomerular filtration rate (GFR) a medication needs to be adjusted. Results: The overall pattern for all post-graduate year (PGY) groups in all medication classes was a lack of awareness and knowledge. For awareness, there were statistically significant increased mean differences for PGY2 and PGY3 as compared to PGY1 for allergy, endocrine, gastrointestinal, and rheumatologic medication classes but not for analgesic,cardiovascular, and neuropsychotropic medication classes. For knowledge, there were statistically significant increased mean differences for PGY2 and PGY3 as compared to PGY1 for allergy, cardiovascular, endocrine, and gastrointestinal, medication classes but not for analgesic, neuropsychotropic, and rheumatologic medication classes. Conclusions: Internal Medicine house-staff across all levels of training demonstrated poor awareness and knowledge for many medication classes in CKD patients. Internal Medicine house-staff should receive more nephrology exposure and formal didactic educational training during residency to better manage complex treatment regimens and prevent medication dosing errors.

Comments

This article was originally published in BMC Nephrology, available at DOI 10.1186/s12882-017-0443-7.

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).