When we argue about proper use of drugs, it is essential to set appropriate dose levels for individual patients. Paying attention to drugs which require dose adjustment in patients with compromised renal function, we selected 5 drugs (allopurinol, amantadine, cibenzoline, digoxin and disopyramide) for this multicenter study designed to investigate: (1) to which extent appropriate dose setting had been practiced on these drugs upon admission of individual patients; and (2) whether or not intervention by pharmacists into dose re-setting was possible when such intervention was needed. Of the 4596 patients studied, 280 carried any of the five drugs prescribed before admission. CKD stage was I in 10 cases and III or higher in 70% of these patients. When rated in accordance with the dose reduction criteria for patients with compromised renal function, the dose level was excessively high for amantadine in 61.5% of all cases, allopurinol in 19.2%, digoxin in 43.8% and cibenzoline in 46.2%. For 32.9% of all cases, dose reduction or discontinuation was implemented under intervention by pharmacists. These results suggest that dose level setting and checking for patients with compromised renal function were not satisfactory. From now on, it seems desirable to facilitate sharing of patients’ renal function data, including dispensing pharmacies, to enable more active intervention by pharmacists.
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