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Medical Students’ and Internal Medicine Trainees’ Knowledge of Drug Prescribing Recommendations in Older Patients with Impaired Kidney Function

Authors Deskur-Smielecka E, Kotlinska-Lemieszek A, Kropinska S, Wieczorowska-Tobis K

Received 17 September 2019

Accepted for publication 5 December 2019

Published 15 January 2020 Volume 2020:15 Pages 53—60

DOI https://doi.org/10.2147/CIA.S231330

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Richard Walker


Ewa Deskur-Smielecka, 1, 2 Aleksandra Kotlinska-Lemieszek, 1, 2 Sylwia Kropinska, 1 Katarzyna Wieczorowska-Tobis 1, 2

1Chair and Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland; 2Palliative Medicine Unit, University Hospital of Lord’s Transfiguration, Poznan, Poland

Correspondence: Ewa Deskur-Smielecka
Chair and Department of Palliative Medicine, Poznan University of Medical Sciences, Osiedle Rusa 55, Poznań 61-245, Poland
Tel/Fax +48 61 8738303
Email edeskur@ump.edu.pl

Background: Numerous medications used in older adults require dose modification or should be avoided in individuals with impaired kidney function.
Purpose: To assess medical students’ and physicians’ knowledge of drug prescribing recommendations in older patients with estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73m 2.
Patients and Methods: A survey comprising a list of 64 drugs conducted in 183 medical students (Students), and 138 post-graduate trainees in internal medicine (Physicians). The respondents were asked to classify each drug into one of three categories: 1) no renal precautions; 2) dose should be reduced; and 3) medication should be avoided.
Results: A range of 16.9– 68.3% students and 14.5– 81.2% physicians correctly classified drugs in the category “No renal precautions.” Drugs requiring dose reduction were correctly classified by 6– 67.2% students, and 24.6– 85.5% physicians. For drugs that should be avoided in subjects with eGFR < 30 mL/min/1.73m 2, the range was 6– 44.8% in the Students, and 8.7– 76.1% in the Physicians. The Physicians did better than the Students by classifying five drugs that do not require renal precautions, 12 drugs requiring dose reduction, and six medications that should be avoided. The Students had a higher percentage of correct answers for seven drugs in the category “no renal precautions,” and one drug requiring dose reduction.
Conclusion: Medical students and post-graduate trainees in internal medicine have poor knowledge of drug prescribing recommendations in older patients with renal impairment.

Keywords: older, chronic kidney disease, reduced glomerular filtration rate, drug dosing, knowledge

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