Harmonizing Formula Prescription Patterns in Patients With Chronic Kidney Disease: A Population-Based Cross-Sectional Study

Hung-Lung Lin; Ming-Yen Lin; Cheng-Hsun Tsai; Yi-Hsiu Wang; Chung-Jen Chen; Shang-Jyh Hwang; Ming-Hong Yen; Yi-Wen Chiu

doi:10.3389/fphar.2021.573145

Harmonizing Formula Prescription Patterns in Patients With Chronic Kidney Disease: A Population-Based Cross-Sectional Study

Front Pharmacol. 2021 Apr 29:12:573145. doi: 10.3389/fphar.2021.573145. eCollection 2021.

Authors

Hung-Lung Lin¹, Ming-Yen Lin^{2

3

4}, Cheng-Hsun Tsai¹, Yi-Hsiu Wang¹, Chung-Jen Chen¹, Shang-Jyh Hwang^{2

4

5

6}, Ming-Hong Yen⁷, Yi-Wen Chiu^{2

4}

Affiliations

¹ Department of Chinese Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
² Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
³ Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei, Taiwan.
⁴ Department of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁵ Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁶ Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
⁷ School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.

Abstract

Objective: Harmonizing formulas are associated with beneficial renal outcomes in chronic kidney disease (CKD), but the therapeutic mechanisms are unclear. The study aims to explore the associations of intentions and independent factors with harmonizing formulas prescriptions for patients with CKD. Methods: We conducted a population-based cross-sectional study to explore factors associated with harmonizing formulas prescription. Patients who had been prescribed harmonizing formulas after CKD diagnosis was defined as the using harmonizing formulas group. Disease diagnoses when having harmonizing formula prescriptions and patient characteristics related to these prescriptions were collected. Results: In total, 24,971 patients were enrolled in this analysis, and 5,237 (21%) patients were prescribed harmonizing formulas after CKD diagnosis. The three most frequent systematic diseases and related health problems for which harmonizing formula prescriptions were issued in CKD were symptoms, signs, and ill-defined conditions (24.5%), diseases of the digestive system (20.67%), and diseases of the musculoskeletal system (12.9%). Higher likelihoods of harmonizing formula prescriptions were associated with young age (adjusted odds ratio: 0.98, 95% confidence interval: 0.97-0.98), female sex (1.79, 1.68-1.91), no diabetes (1.20, 1.06-1.36), no hypertension (1.38, 1.27-1.50), no cerebrovascular disease (1.34, 1.14-1.56), less disease severity (0.85, 0.83-0.88), using nonsteroidal anti-inflammatory drugs (NSAIDs) (1.65, 1.54-1.78), and using analgesic drugs other than NSAIDs (1.47, 1.35-1.59). Conclusion: Harmonizing formulas are commonly used for treating symptoms of the digestive and musculoskeletal systems in CKD cases. Further research on harmonizing formula effectiveness with regard to particular characteristics of CKD patients is warranted.

Keywords: Chinese herbal formula; Chinese herbal medicine; chronic kidney disease; prescription patterns; traditional Chinese medicine.