Background:The potential impact of pharmacist interventions could improve health outcomes of patients with anemia. However, this attempt has not been documented yet in the developing countries. Aim of the study is to investigate the effect of pharmacist interventions in optimizing management of anemia associated with chronic kidney disease. Methods: An interventional randomized control trial was carried out on 120 anemic patients on hemodialysis for eight months. The impact of the pharmacist's interventions in optimizing anemia management to reach hemoglobin target were investigated. Data were analyzed by GraphPad Prism version 8.2.1. Results: During 16-week period, 1646 interventions and recommendations were performed. The interventions were at the physician, patients, drugs, hospital and administrative level. At the physician level a total of 180 (10.9%) recommendations were proposed, at the drug level, the pharmacist provided 595 (36.1%) interventions which were mainly related to erythropoietin and iron dose adjustment. At the patient and the hospital level 734 (44.6%) and 137 (8.3%) interventions have been made respectively. Hemoglobin level increased significantly to (11.25 ± 2.29) after 16-weeks in interventional group (p-value <0.5), while in non-interventional group it was increased to (9.99 ± 2.54) at 16 th week although the change was significant compare to the baseline level but it has not reached the target hemoglobin level. In the interventional group 39 (65%) patients reached the target hemoglobin while it was 25 (41.6%) in non-interventional group with a significant difference between both groups (p-value=0.017). Conclusion: In conclusion the implementation of pharmacist intervention in patients with chronic kidney disease-associated anemia improved hemoglobin level and healthcare outcomes.

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