Patients with end-stage renal disease are a unique population requiring special attention to drug use and dosing due to significantly altered pharmacokinetics, tendency to polypharmacy, and comorbid risk factors. Many medications are either completely contraindicated, or if used, must be dose reduced to reduce risk of adverse events. Adverse drug reactions (ADRs) are known to lead to emergency room visits, hospitalization, and/or prolonged hospitalization in the general population, but to what extent ADRs contribute to the high admission rates and long lengths of stay in patients with ESRD is uncertain.The purpose of this project is to implement cost-efficient strategies that are embedded into routine clinical practice, involving the entire health care team and patients, in order to reduce the incidence of ADRs.

Aims:

i) To determine the rate of preventable ADRs in ESRD patients over the last 24 months at the MUHC resulting in emergency room visits, hospitalization, or prolonged length of stay.

ii)  To identify modifiable risk system-related factors for these ADRs.

iii) To develop and implement tools and strategies addressing these factors in order to reduce rates of hospital ADRs.