Evaluation of Drug-Related Problems in Non-Dialysis Chronic Kidney Disease at Northwest General Hospital Peshawar: A Cross-Sectional Study

Abstract

Background: Chronic kidney disease (CKD) is a progressive condition associated with substantial morbidity, polypharmacy, and altered drug pharmacokinetics, placing patients at high risk of drug-related problems (DRPs). Non-dialysis CKD (ND-CKD) patients, in particular, face increased vulnerability to adverse drug events and drug–drug interactions (DDIs), necessitating proactive pharmaceutical care. Objective: This study aimed to evaluate the prevalence, causes, and clinical outcomes of DRPs in ND-CKD patients, assess the nature and acceptance of pharmacist-led interventions, and identify associations between Pharmaceutical Care Network Europe (PCNE) domains and DRP outcomes. Methods: A cross-sectional study was conducted among 157 ND-CKD inpatients at Northwest General Hospital, Peshawar. DRPs were identified and classified using PCNE version 9.1, and DDIs were analyzed via Lexicomp®. Data were analyzed using descriptive statistics and multivariate logistic regression. Results: A total of 254 DRPs were identified, predominantly due to inappropriate drug selection (42.91%) and patient-related factors (26.77%). Lexicomp® detected 157 DDIs, with Category C interactions most common (68.8%). Of 278 pharmacist interventions, 80.21% were accepted, and 44.96% of DRPs were completely resolved. Significant associations were found between DRP causes, intervention acceptance, and outcomes (p<0.05). Conclusion: DRPs are frequent in ND-CKD and predominantly preventable. Pharmacist-led interventions significantly improve therapeutic safety, highlighting the need for their integration into renal care.