{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:07:49Z","timestamp":1788847669134,"version":"build-2803163510"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010067","name":"Gobierno de Arag\u00f3n","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010067","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      to determine the proportion of patients aged 75 years or older with chronic kidney disease and an estimated glomerular filtration rate &amp;lt;60\u00a0mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      , for whom at least one medication-related treatment modification was proposed following the structured review.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A single-centre, uncontrolled longitudinal study evaluating a structured medication review and the subsequent implementation of proposed treatment modifications was conducted in patients aged 75 years or older with an estimated glomerular filtration rate below 60\u00a0mL\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      . Data was obtained from laboratory systems, medical records, and electronic prescribing. Chronic medication was reviewed using a structured therapeutic appropriateness guide according to renal function. Sociodemographic variables, comorbidity, polypharmacy, need for intervention, and changes made after the treatment modifications were analysed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 1,937 patients aged \u226575 years registered at the primary care centre, 178 met the study eligibility criteria based on a recorded eGFR &amp;lt;60\u00a0mL\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      . Mean age was 86.2 years, 69.6% were women, and 88.7% were exposed to polypharmacy. At least one medication-related treatment modification was proposed for 111 patients (62.4%), with 215 individual modifications proposed overall. The therapeutic groups with the greatest need for intervention were analgesics and non-steroidal anti-inflammatory drugs, oral antidiabetic agents, and antihypertensive drugs. At follow-up, corresponding prescription changes were observed for 114 of the 215 proposed modifications (53.0%). At the patient level, at least one corresponding prescription change was observed in 64 of the 111 patients for whom one or more modifications had been proposed (57.7%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The structured medication review identified a substantial number of potential medication-related problems and proposed treatment modifications in older patients with reduced renal function. Approximately half of the proposed modifications were observed in the electronic prescription at follow-up. However, because the study lacked a control group, the extent to which these changes were attributable to the structured review cannot be determined.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1915807","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:35:29Z","timestamp":1788845729000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Structured medication review in elderly patients with chronic kidney disease to assess treatment appropriateness"],"prefix":"10.3389","volume":"17","author":[{"given":"Gloria","family":"Navarro-Azn\u00e1rez","sequence":"first","affiliation":[{"name":"Aragonese Healthcare Service (SALUD)","place":["Zaragoza, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herminia","family":"Navarro-Azn\u00e1rez","sequence":"additional","affiliation":[{"name":"Aragonese Healthcare Service (SALUD)","place":["Zaragoza, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Teresa","family":"Garc\u00eda-Ruiz","sequence":"additional","affiliation":[{"name":"Aragonese Healthcare Service (SALUD)","place":["Zaragoza, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Galino-Serrano","sequence":"additional","affiliation":[{"name":"Aragonese Healthcare Service (SALUD)","place":["Zaragoza, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosal\u00eda","family":"D\u00edaz-Royo","sequence":"additional","affiliation":[{"name":"Aragonese Healthcare Service (SALUD)","place":["Zaragoza, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Balongo-Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Aragonese Healthcare Service (SALUD)","place":["Zaragoza, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Berges-Mata","sequence":"additional","affiliation":[{"name":"Aragonese Healthcare Service (SALUD)","place":["Zaragoza, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F\u00e1tima","family":"M\u00e9ndez-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Department of Physiatry and Nursery, Universidad de Zaragoza","place":["Zaragoza, Spain"]},{"name":"Aragonese Primary Care Research Group, Institute for Health Research Arag\u00f3n","place":["Zaragoza, Spain"]},{"name":"Research Network on Chronicity, Primary Care and Health Promotion RD24\/0005\/0004","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Antonia","family":"S\u00e1nchez-Calavera","sequence":"additional","affiliation":[{"name":"Aragonese Healthcare Service (SALUD)","place":["Zaragoza, Spain"]},{"name":"Aragonese Primary Care Research Group, Institute for Health Research Arag\u00f3n","place":["Zaragoza, Spain"]},{"name":"Research Network on Chronicity, Primary Care and Health Promotion RD24\/0005\/0004","place":["Madrid, Spain"]},{"name":"Department of Medicine, Psychiatry and Dermatology. 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