薬理と治療

Abstract

Objectives　When pharmacists prepare medications for dialysis patients, they often have the impression that the patients receive too many medicines, or what they call“Heavy Prescriptions.” We investigated the prescriptions for dialysis patients and what pharmacists think about them. Methods　1．We examined 332 periodical prescriptions in four maintenance hemodialysis facilities. We classified the prescribed medicines based on pharmacotherapeutic class and summed them up in each class. 2．Twenty pharmacists filled out a questionnaire to express their views on prescriptions for dialysis patients. Results1．On average, 9.42 medicines were prescribed per person. Overall, 3128 medicines were prescribed: 22.4％ were antihypertensives, 19.2％ were specific agents for dialysis （including phosphate binders, potassium binders, cinacalcet, and nalfurafine）, 9.1％ were anti-gastric ulcer agents, and 8.1％ were anti-thrombotic agents. In four facilities almost the same medicines were prescribed, and in almost the same manner. 2．Seventy-percent of the pharmacists answered that too many medicines were prescribed. Sixty-percent answered that medications could be reduced. ConclusionsThe prescription records showed that dialysis patients received 9.42 medicines per person. This was consistent with the pharmacistsʼ belief that dialysis patients receive too many medicines. Decreased medication of dialysis patients would prevent side effects caused by drug accumulation and drug interactions. It also could be potentially useful for reforming the medical economy. Pharmacists should participate in the planning of medication regimens for dialysis patients.