{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:58:39Z","timestamp":1777384719616,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hospice-eligible patients are vulnerable to adverse medication effects given their advanced illnesses and general older age. It is not known how often medications are not renal dose adjusted in hospice-eligible patients and which are frequently problematic. This study aims to identify commonly prescribed medications with significant renal clearance that are dosed too high and patient characteristics that increase the likelihood of occurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective chart review of adult patients admitted to hospice care. Data collected included clinical\/demographic data, renally cleared medications taken at time of hospice admission, and calculated renal function using several formulas. Descriptive statistics and binomial logistic regression were used to analyze data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 283 included charts, 27% had \u22651 medication dosed too high for renal function. The most common medications prescribed and not renal dose adjusted included tramadol, gabapentin, duloxetine, loratadine, cetirizine, famotidine, apixaban, rivaroxaban, metformin, trospium, and most antimicrobials. Increasing serum creatinine values and increasing number of renally cleared medications were associated with a higher likelihood of a medication dosed too high [OR, 1.702, 95% CI (1.257, 2.305),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001] and [OR, 1.856, 95% CI (1.517, 2.271),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001] respectively. Residing at home vs a facility was associated with a reduced likelihood of having a medication dosed too high [OR, 0.30, 95% CI (0.134, 0.673),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003.].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hospice-eligible patients frequently have renally cleared medications prescribed and at doses too high for their renal function. Analgesics, over-the-counter antihistamines, anticoagulants, anticholinergics have potential for significant adverse effects and higher vigilance is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091251323284","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T07:53:02Z","timestamp":1740383582000},"page":"234-241","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Medications Not Dosed Within Recommended Range for Renal Function in Patients With Chronic Kidney Disease Identified upon Hospice Admission; a Retrospective Chart Review"],"prefix":"10.1177","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4468-602X","authenticated-orcid":false,"given":"Natalie M.","family":"Latuga","sequence":"first","affiliation":[{"name":"Hospice & Palliative Care Buffalo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1088-4324","authenticated-orcid":false,"given":"Kathryn","family":"Levy","sequence":"additional","affiliation":[{"name":"Hospice & Palliative Care Buffalo"},{"name":"Trocaire College"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1553-7250(05)31066-x"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.5414\/CP203258"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13790"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-021-01099-3"},{"key":"e_1_3_4_6_2","volume-title":"Chronic Kidney Disease in the United States","author":"Centers for Disease Control and Prevention","year":"2021","unstructured":"Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2021. Available at: https:\/\/www.cdc.gov\/kidneydisease\/publications-resources\/ckd-national-facts.html"},{"key":"e_1_3_4_7_2","unstructured":"NHPCO Facts and Figures 2023 Edition. National Hospice and Palliative Care Organization; 2023. Available at: https:\/\/www.nhpco.org\/wp-content\/uploads\/NHPCO-Facts-Figures-2023.pdf"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2014.0421"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/082585979601200102"},{"key":"e_1_3_4_10_2","volume-title":"Indianapolis","author":"Cymbalta [Package Insert]","year":"2023","unstructured":"Cymbalta [Package Insert]. Indianapolis. Eli Lilly and Company; 2023."},{"key":"e_1_3_4_11_2","volume-title":"Amneal Pharmaceuticals","author":"Tramadol [Package Insert]","year":"2021","unstructured":"Tramadol [Package Insert], Glasgow KY. Amneal Pharmaceuticals. LLC; 2021."},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-323-84702-5.00004-X"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18372"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2006.05.005"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/106002808802201209"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S130583"},{"key":"e_1_3_4_17_2","volume-title":"Data Analysis, and Impact on Dosing and Labeling","author":"U.S. Food and Drug Administration (FDA)","year":"2017","unstructured":"U.S. Food and Drug Administration (FDA). Guidance for industry: pharmacokinetics in patients with impaired renal function \u2013 study design. In: Data Analysis, and Impact on Dosing and Labeling; 2017."},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1592\/phco.30.8.776"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2021.08.003"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2020.04.010"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1282"},{"issue":"4","key":"e_1_3_4_22_2","first-page":"279","article-title":"Identifying the pattern and risk factors for potential medication dosing errors in chronic renal impairment of critically ill patients","volume":"7","author":"Sedaghat B","year":"2021","unstructured":"Sedaghat B, Abbasi S, Farsaei S. Identifying the pattern and risk factors for potential medication dosing errors in chronic renal impairment of critically ill patients. 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