Seguimiento farmacoterapéutico en pacientes con enfermedad renal crónica atendidos en el Hospital General Machala.

Abstract

Chronic kidney disease (CKD) represents a global public health challenge, with high prevalence and significant health costs, especially in patients with comorbidities such as hypertension and diabetes. The objective of this study was to apply a pharmacotherapeutic follow-up program in patients with CKD at the General Hospital of Machala, using the Dáder method to improve the quality of life of patients. This study was conducted at the Machala General Hospital of the Ecuadorian Institute of Social Security (IESS), applying a pharmacotherapeutic follow-up program in 41 patients with CKD. The design was non-experimental, observational and descriptive, developed between March and July 2025. The participants, over 18 years of age, were selected by non-probabilistic convenience sampling. Follow-up was performed using the Dáder method, which included interviews, evaluation of the pharmacological profile and telephone monitoring. The phases included sociodemographic data collection, analysis of prescribed medications, identification of medication-related problems (DRP), interactions, adverse effects and medication-associated negative outcomes (MAR). The information was processed with descriptive statistical tools, allowing the assessment of adherence to treatment, clinical effectiveness and therapeutic safety. The results showed that 82.93% of the patients had polypharmacy (average of 6.35 drugs), with a higher frequency in advanced stages of CKD. Moderate (71.25%) and severe (18.75%) drug interactions were common, with combinations such as aspirincarvedilol, amlodipine-simvastatin, losartan-aspirin, among others, standing out. Pharmacotherapeutic follow-up showed a reduction in DRP, such as adverse reactions (from 2 to 0 cases) and medication forgetfulness (from 24 to 13 cases). In addition, prevalent comorbidities were identified, such as arterial hypertension (33.61%) and diabetes (13.45%). This, the study showed the complexity of pharmacological management in CKD, highlighting the need for continuous follow-up to minimize risks and improve adherence, demonstrating that pharmaceutical intervention was key to optimizing treatment and reducing negative outcomes associated with medication.