Clinical pharmacist as a member of the multidisciplinary kidney care team in low‐ and middle‐income countries: An opportunity to reduce the incidence of drug‐related problems

Abstract

The multiple comorbidities, complications, and polypharmacy coupled with pharmacokinetic and pharmacodynamics changes linked to chronic kidney disease (CKD) predispose patients with this disease to a huge number of drug-related problems (DRPs).Evidence has shown that a clinical pharmacist (CP) is an integral member of the multidisciplinary kidney care team in most high-income countries (HICs). In the team, CP provides patient-centered care, including detection, prevention, and resolution of DRPs, and helping patients overcome challenges to improve drug adherence. Pharmaceutical care in CKD has demonstrated positive economic, clinical, and humanistic outcomes including reduced DRPs, all-cause hospital admission, length of hospital stays, the incidence of end-stage renal disease, and mortality, improved drug knowledge, adherence, health-related quality of life among others. The purpose of this article is to highlight the gaps in drug-related care for patients with CKD in low-and middle-income countries (LMICs), demonstrate that clinical pharmacy services have the capacity to reduce these gaps, identify barriers that hinder its implementation in LMICs and offer recommendations capable of mitigating the identified barriers.