Determination of drug-related problems according to PAIR criteria in dialysis patients: a cross-sectional study in tertiary care hospital

• Published in: BMC pharmacology & toxicology Vol. 25; no. 1; p. 28
• Main Authors: Pehlivanli, Aysel, Akkan Eren, Sayeste, Sengul, Sule, Basgut, Bilgen, Erturk, Sehsuvar, Ozcelikay, A Tanju
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 18-04-2024; BioMed Central
• Subjects: Adult; Aged; Chronic kidney failure; Comorbidity; Correlation coefficient; Correlation coefficients; Criteria; Cross-Sectional Studies; Culture; Diabetes; Dialysis; Drug therapy; Drug-Related Side Effects and Adverse Reactions; Drugs; Female; Health aspects; Hemodialysis; Hospitals; Humans; Hypertension; Intelligibility; Kidney diseases; Male; Medical research; Medicine, Experimental; Middle Aged; Morbidity; Mortality; Nephrology; Observational studies; Patients; Peritoneal dialysis; Pharmacists; Polypharmacy; Quality of Life; Reliability; Reliability analysis; Renal Dialysis; Renal Insufficiency, Chronic - therapy; Reproducibility of Results; Sensory evaluation; Statistical analysis; Tertiary Care Centers; Translation; Trimetazidine; United States; Validity; United States; Ankara Turkey; Turkey; Chronic kidney disease; Drug-related problem; PAIR criteria; PCNE; Validation study
• DOI: 10.1186/s40360-024-00754-6
• EISSN: 2050-6511

Dialysis patients are at high risk for drug-related problems (DRPs), which have significant consequences for their morbidity, mortality, and quality of life. Improved clinical outcomes can be achieved by preventing, identifying, and resolving these problems.
This is a retrospective observational study. In this study, the PAIR instrument (Pharmacotherapy Assessment in Chronic Renal Disease) was validated for use in Turkish. Validation consisted of three stages: translation back-translation with expert panel evaluation, reliability analysis using the test-retest method, and conceptual validity with both Pharmaceutical Care Network Europe (PCNE) and PAIR used to determine DRPs prevalence.
In total, 104 patients (mean ± SD age, 54.1 ± 15.8 years; 53.8% male) were included in the study. An expert panel evaluated the items in the criterion based on their intelligibility, service of purpose, differentiation, and cultural suitability during the translation stage. Content validity index (CVI) score was found to be 0.95. The reliability analysis was performed by applying the test-retest method and calculating correlation coefficient on 30 randomly selected patients one month later. Correlation coefficient (p) was found to be 0.8. To evaluate conceptual validity, 104 patients' pharmacotherapy plans were assessed using both the PAIR and PCNE criteria. The prevalence of DRPs according to PAIR criteria (100.0%) and PCNE (73.1%) were statistically significantly different (p < 0.001).
As a result, PAIR criteria can identify clinically relevant DRPs in patients with CKD and is a new, validated tool to be used in Turkey, but may not be adequate for patients receiving dialysis. Therefore, it needs to be reviewed and updated for dialysis patients.