Abstract
Older adults are at higher risk of inappropriate dosing of renally excreted drugs owing to polypharmacy and age-related renal decline. In home care and long-term care facilities (LTCFs), renal function assessment is often limited, and prescriptions frequently rely on outdated laboratory data. Herein, we evaluated the utility of portable point-of-care testing (POCT) for onsite renal assessment to optimize drug dosing. Seventy-one participants were enrolled, including 46 home care patients and 25 LTCF residents. Potential overdosing was identified in four home care patients and in seven LTCF residents. Dose adjustments were implemented in all home care patients, whereas no changes were made for patients at LTCFs. Among the LTCF residents, prior venous creatinine values obtained 1-19 months earlier differed from the on-site POCT values by −0.44 to +0.40 mg/dL. POCT enabled timely assessment of renal function; however, its clinical impact may depend on the healthcare delivery system. In conclusion, POCT may support safer dosing of renally excreted drugs.
