Episode 45: Medication Safety in Chronic Kidney Disease

January 8, 2016

Dr. Chandra Thomas

In this episode Dr. Chandra Thomas talks about safety related to medications in patients with Chronic Kidney Disease (CKD).  Individuals with CKD are at very high risk for medication incidents associated with enormous costs for the society and the individuals.

CKD is common but many people are unaware that they have it. Several studies show that often individuals with advanced kidney disease don’t know about their health condition and consequently don’t express any concern to their primary healthcare provider and their pharmacist.  Often family physicians don’t recognize that individuals have CKD and this leads to severe consequences for patients and the health care system in general.

Chandra explains the complexity and uniqueness of patients with CKD. These are patients with multiple comorbidities and multiple care providers. Often in their illness pathway they experience several transitions of care, moving between hospitals, clinics and home. They also have to take many medications, need specific monitoring and are at high risk for nephrotoxicity.  Consequently, something must be done to prevent medication incidents in this particular population of patients, and Chandra suggests looking at medication safety from a system perspective.

Finally, Chandra describes her approach with her patients and how she values the use of technology as a way to facilitate the communication between physicians, patients and family members. She also mentions the benefits of mobile applications for people at high risk of adverse events.  And lastly she lists various initiatives in Canada that have been developed to increase medication safety in patients with CKD.

After listening to this podcast listeners will be able to:
Understand the risks for medication related safety incidents in patients with CKD
Know the complexity and uniqueness of individuals with CKD
Recognize a need for actions that supports medication safety

Chandra Thomas, Clinical Assistant Professor of Medicine, Nephrology
Dr. Thomas is an academic nephrologist at the University of Calgary. She has an interest in medication safety and palliative care for individuals with chronic kidney disease. Dr. Thomas is the co-lead for quality improvement within the Division of Nephrology and has been very involved in efforts to improve medication safety for individuals within the Southern Alberta Renal Program. She was awarded the University of Calgary, Department of Medicine Quality Improvement and Patient Safety Award for her leadership work in medication reconciliation in 2014. She is the medical lead for the integrated palliative care and advance care planning programs within the Southern Alberta Renal Program. Under her leadership a comprehensive conservative care program was established in 2009 and she is active in disseminating the learning from this program across Canada.

In her spare time she tries to perfect her composting operation and optimize food production in her urban food forest garden while keeping track of her energetic son.