Prescribing patterns and health-related quality of life in patients with chronic kidney disease: a cross-sectional study

Susheela Rani S.; Imran Najir Khan; Anjana P.; Aayushi

doi:10.18203/2320-6012.ijrms20263537

Authors

Susheela Rani S. Department of Pharmacy Practice, Acharya and BM Reddy College of Pharmacy, Soldevanahalli, Achit Nagar, Bengaluru, Karnataka, India
Imran Najir Khan Department of Pharmacy Practice, Acharya and BM Reddy College of Pharmacy, Soldevanahalli, Achit Nagar, Bengaluru, Karnataka, India
Anjana P. Department of Pharmacy Practice, Acharya and BM Reddy College of Pharmacy, Soldevanahalli, Achit Nagar, Bengaluru, Karnataka, India
Aayushi Department of Pharmacy Practice, Acharya and BM Reddy College of Pharmacy, Soldevanahalli, Achit Nagar, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20263537

Keywords:

Chronic kidney disease, Drug prescribing, Polypharmacy, Health-related quality of life, RAND-36

Abstract

Background: Chronic kidney disease (CKD) is associated with multimorbidity, polypharmacy, and impaired health-related quality of life (HRQoL). This study evaluated prescribing patterns using World Health Organization (WHO) core prescribing indicators and HRQoL using the RAND 36-item health survey 1.0 among patients with CKD.

Methods: A cross-sectional observational study was conducted among 162 adults with CKD in India. Prescribing patterns were assessed using WHO core prescribing indicators, and HRQoL was evaluated using the RAND-36 questionnaire. Associations between prescribing burden, patient characteristics, and physical component summary (PCS) and mental component summary (MCS) scores were analysed.

Results: The mean number of drugs per encounter was 12.77±3.68. Generic prescribing (38.64%) and essential medicines list (EML) adherence (61.57%) were below WHO benchmarks, while injection prescribing (29.23%) exceeded recommendations. Cardiovascular agents were the most frequently prescribed drug class (34.26%). HRQoL was impaired across all domains (PCS: 30.23±6.57; MCS: 35.30±5.30). Advancing CKD stage was associated with lower PCS and MCS (both p<0.001). Older age was associated with lower PCS (p<0.001), whereas higher medication burden was associated with lower MCS (p=0.034). Medication burden was also associated with greater comorbidity burden (p=0.007) and longer hospitalisation (p<0.001).

Conclusions: Patients with CKD experienced substantial polypharmacy, suboptimal adherence to WHO prescribing indicators, and impaired HRQoL. These findings highlight the need for rational prescribing, medication review, and routine patient-reported outcome assessment.

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