Deprescribing Intervention for Patients With Chronic Kidney Disease

Percentage of participants with at least one Potentially inappropriate medications (PIMs),Number of Potentially inappropriate medications (PIMs)

Chronic Kidney Disease (CKD) is recognized as a leading health problem globally. It is
 associated with multiple consequences such as cardiovascular diseases, infections, reduced
 cognitive function, and higher mortality rates. In Qatar, it is estimated that 13% of the
 population suffers from CKD. Management of CKD is associated with polypharmacy (the use of
 multiple medications), which burdens the patients and leads to adverse health and economic
 outcomes. As documented by previous studies, CKD setting is associated with a high medication
 burden, which leads to non-adherence, reduced quality of life, and other negative sequelae.
 These consequences can be minimized or averted by implementing a deprescribing program.
 Deprescribing is defined as the supervised process of intentionally stopping a medication,
 altering the dose or introducing a safer alternative to improve a person's clinical and
 quality of life outcomes. Previous deprescribing initiatives in inpatient and outpatient
 hospital settings were successfully implemented.
 
 In general, there are limited deprescribing initiatives in CKD settings. There is a need to
 provide evidence of the impact of deprescribing programs on improving clinical and economic
 outcomes in this setting. In Qatar, there is no evidence of the effectiveness of implementing
 deprescribing programs in clinical settings. Therefore, we have built a team of researchers,
 clinicians, and stakeholders, and initiated a collaboration with deprescribing experts to fit
 into the Qatar healthcare system. This project aims to initiate a deprescribing
 multidisciplinary team and to evaluate the impact of providing such services on the clinical
 and economic outcomes among CKD patients in Qatar using a randomized controlled trial
 approach. The findings could have a potential positive impact on the professional practice
 and patient safety represented by health and economic outcomes.