Availability of information on renal function in Dutch community pharmacies

Koster, Ellen S.; Philbert, Daphne; Noordam, Michelle; Winters, Nina A.; Blom, Lyda; Bouvy, Marcel L.

doi:10.1007/s11096-016-0332-3

Cited by 8 publications

(6 citation statements)

References 8 publications

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“…Chronic kidney disease is a common health issue worldwide, affecting around 3 million people in France [ 5 ]. However, in many countries [ 6 ], including France [ 5 ], community pharmacists (CPs) cannot yet freely access laboratory data, including the estimated glomerular filtration rate (eGFR), which is currently the best available indicator of overall kidney function (and thus of renal impairment) [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The Role of Community Pharmacists in the Detection of Clinically Relevant Drug-Related Problems in Chronic Kidney Disease Patients

et al. 2020

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Community pharmacists (CPs) have traditionally had limited access to patients’ estimated glomerular filtration rate (eGFR) during the medication-dispensing process. The increasing access to shared electronic health records is making eGFR available, but the skills needed to detect and manage clinically relevant drug-related problems (DRPs) are poorly documented. The primary objective of this study was to investigate the role of CPs in the medication-dispensation process for elderly patients with renal impairment. A total of 70 CPs participated in this 6 month study. Community pharmacists asked all patients ≥65 years to bring their laboratory test values for the next medication-dispensing process. Drug-related problem detection rates were compared between CPs (prospective period) and expert pharmacists (retrospectively). The clinical relevance of each DRP was assessed by nephrologists and general practitioners using an appropriate tool. Community pharmacists recruited n = 442 patients with eGFR < 60 mL/min/1.73 m2 and detected n = 99 DRPs, whereas expert pharmacists detected n = 184 DRPs. The most frequently detected DRPs were dosage problems and contraindications. According to assessment by clinicians, CPs and expert pharmacists identified 54.0% and 84.7% of clinically relevant DRPs, respectively. This study suggests a positive impact of the systematic availability of eGFR to CPs on the detection of several DRPs with clinical relevance.

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Section: Introductionmentioning

confidence: 99%

The Role of Community Pharmacists in the Detection of Clinically Relevant Drug-Related Problems in Chronic Kidney Disease Patients

et al. 2020

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“…By the end of the study period, a renal function was registered for about 75% of the patients. This percentage is in the upper range of results from some recent surveys about the availability of information on renal function in community pharmacy [ 16 , 17 ]. This suggests that the routine use of the CDSS can contribute to better documentation of renal function.…”

Section: Discussionmentioning

confidence: 72%

Clinical Decision Support and Optional Point of Care Testing of Renal Function for Safe Use of Antibiotics in Elderly Patients: A Retrospective Study in Community Pharmacy Practice

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Floor-Schreudering

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et al. 2017

Drugs Aging

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ObjectiveThe aim was to investigate the management of drug therapy alerts on safe use of antibiotics in elderly patients with (potential) renal impairment and the contribution of optional creatinine point of care testing (PoCT) in community pharmacy practice.MethodsCommunity pharmacists used a clinical decision support system (CDSS) for seven antibiotics. Alerts were generated during prescription processing in the case of previously registered renal impairment and when no information on renal function was available for patients aged 70 and over. Pharmacists could perform PoCT when renal function could not be retrieved from other health care professionals. Actions were registered in the CDSS. A retrospective descriptive analysis of alert management, performed PoCT and medication dispensing histories was performed.ResultsA total of 351 pharmacists registered the management of 88,391 alerts for 64,763 patients. For 68,721 alerts (77.7%), the pharmacist retrieved a renal function above the threshold for intervention. 1.7% of the alerts (n = 1532) led to a prescription modification because of renal impairment; in 3.0% of the alerts (n = 2631), the patient had renal impairment, but the pharmacist judged that no intervention was needed. Pharmacists performed 1988 PoCTs (2.2% of the alerts), which led to 15 prescription modifications (0.8% of the PoCT).ConclusionCommunity pharmacists performed CDSS-based interventions to prevent potentially inappropriate (dosing of) antibiotics in elderly patients with renal impairment. Pharmacists were well able to retrieve information on renal function, using PoCT in a limited number of cases. The intervention rate could be greatly increased by better registration of information on renal function. Performing PoCT seems especially worthwhile in the highest age groups.

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“…Impaired kidney function has often been associated with an increased risk of medication-related hospitalizations and adverse drug reactions (Leendertse et al, 2008; Onder et al, 2010; Sikdar et al, 2012). However, in the Dutch setting this might be less relevant as criterion since community pharmacists already monitor medication safety in patients with a reduced kidney function (Koster et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Development and Piloting of an Algorithm to Select Older Patients for Different Types of Medication Review

et al. 2019

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Aim: To develop and pilot an algorithm to select older people for different types of medication review based on their case complexity.Methods: Experts rated complexity of patient cases through a Delphi-consensus method. The case characteristics were included in a regression model predicting complexity to develop a criteria-based algorithm. The algorithm was piloted in four community pharmacies with 38 patients of high and low complexity. Pharmacists conducted medication reviews according to their personal judgment and rated the patients' complexity. Time needed for reviewing and number of interventions (proposed and implemented) were assessed. Feasibility was evaluated with in-depth interviews.Results: We developed the algorithm with 75 cases proceeding from patients in average 79 years old and using 10 prescribed medications. The regression model (adjusted R2 = 0.726, P < 0.0001) resulted in the following criteria for the algorithm: “number of medications” × 1 + “number of prescribers” × 3 + “recent fall incident” × 7 + “does not collect own medication” × 4. The pharmacists performed advanced medication reviews with all patients. The time needed to perform the medication review did not differ significantly according to case complexity (76.9 min for high complexity; 66.1 min for low complexity). Agreement between the algorithm scores and the pharmacists' ratings on complexity degree was slight to moderate (Kappa 0.16–0.42). The pharmacists had mixed opinions about the feasibility of applying the algorithm, particularly regarding the criterion “fall incidents.”Conclusion: We developed an algorithm with four criteria that distinguished between high and low complexity patients as rated by experts. Additional validation steps are needed before implementation.

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Availability of information on renal function in Dutch community pharmacies

Cited by 8 publications

References 8 publications

The Role of Community Pharmacists in the Detection of Clinically Relevant Drug-Related Problems in Chronic Kidney Disease Patients

The Role of Community Pharmacists in the Detection of Clinically Relevant Drug-Related Problems in Chronic Kidney Disease Patients

Clinical Decision Support and Optional Point of Care Testing of Renal Function for Safe Use of Antibiotics in Elderly Patients: A Retrospective Study in Community Pharmacy Practice

Development and Piloting of an Algorithm to Select Older Patients for Different Types of Medication Review

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