Awareness and Knowledge Among Internal Medicine House-Staff for Dose Adjustment of Cardiovascular Drugs in Chronic Kidney Disease.
Adult
Cardiovascular Agents
/ administration & dosage
Cardiovascular Diseases
/ complications
Cross-Sectional Studies
Drug Dosage Calculations
Female
Glomerular Filtration Rate
Health Care Surveys
Health Knowledge, Attitudes, Practice
Humans
Internal Medicine
Kidney
/ physiopathology
Male
Medical Staff, Hospital
Renal Insufficiency, Chronic
/ complications
Risk Assessment
Risk Factors
Cardiovascular agents
Chronic kidney disease
Drug dosing errors
Internal medicine
Internship and residency
Journal
High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension
ISSN: 1179-1985
Titre abrégé: High Blood Press Cardiovasc Prev
Pays: New Zealand
ID NLM: 9421087
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
10
11
2020
accepted:
08
02
2021
pubmed:
25
2
2021
medline:
7
4
2021
entrez:
24
2
2021
Statut:
ppublish
Résumé
Patients with chronic kidney disease (CKD) are vulnerable to adverse-drug events from cardiovascular drugs. To evaluate awareness and knowledge for appropriate dose adjustment of cardiovascular drugs in CKD patients among Internal Medicine house-staff (IMHS). Cross-sectional convenience sample survey in Fall 2015 among 341 IMHS from multiple academic institutions in the suburban New York City metropolitan area. Awareness was whether drug dose adjustment was needed. Knowledge was correct GFR level for drug dose adjustment. Multivariate logistic regression was conducted. We found overall high percentages and high odds for all cardiovascular drugs for incorrect awareness and knowledge. Postgraduate year (PGY)-1 had greater odds than PGY-3 for Carvedilol (OR: 5.56, 95% CI: 2.19-14.12, p < 0.001) and Digoxin (OR: 3.87, 95% CI: 1.37-10.95, p < 0.05), and lesser odds than PGY3 for Atenolol (OR: 0.31, 95% CI: 0.10-0.91, p < 0.05). Nephrology exposure during medical school rotation, renal clinic, or family history had lesser odds for Carvedilol (OR: 0.45, 95% CI: 0.21-0.97, p < 0.05), Simvastatin (OR: 0.40, 95% CI: 0.16-0.97, p < 0.05), and Hydralazine (OR: 0.31, 95% CI: 0.12-0.81, p < 0.05). Nephrology exposure during residency (OR: 1.96, 95% CI: 1.10-3.50, p < 0.05) and US osteopathic graduates (OR: 2.40, 95% CI: 1.04-5.50, p < 0.05) each had greater odds for Enalapril (OR: 2.40, 95% CI: 1.04-5.50, p < 0.05). International medical graduates had lesser odds than US graduates for Amlodipine (OR: 0.30, 95% CI: 0.11-0.82, p < 0.05). IMHS had overall poor awareness and knowledge for dose adjustment for common cardiovascular drugs in patients with CKD. As the majority of CKD patients are managed by their primary care providers, training programs should ensure that IMHS have adequate education in Nephrology during their residency training.
Identifiants
pubmed: 33625694
doi: 10.1007/s40292-021-00438-w
pii: 10.1007/s40292-021-00438-w
doi:
Substances chimiques
Cardiovascular Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
177-184Références
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