Community pharmacist intervention in patients with renal impairment

Pourrat, Xavier; Sipert, Anne-Sophie; Gatault, Philippe; Sautenet, Bénédicte; Hay, Nicolas; Guinard, Francis; Guegan, F.; Halimi, Jean‐Michel

doi:10.1007/s11096-015-0182-4

Cited by 20 publications

(35 citation statements)

References 16 publications

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“…While almost half of the studies were cross‐sectional, 21 studies implemented interventions to reduce IP . Of these interventions, almost half were manual decision aids (n = 10), others were computerised decision support aids to physicians and pharmacists (n=9) and in the remaining studies (n=2), physicians were prompted with calculated eGFR values (Figure ).…”

Section: Resultsmentioning

confidence: 99%

“…Forty‐three of the included studies were rated as moderate or high quality (can be accessed on supporting information). All studies defined their inclusion criteria and evaluated IP objectively with comparators described clearly, where applicable .…”

Section: Resultsmentioning

confidence: 99%

“…Most studies have used the CG to estimate renal function for drug dosing (n=26), whereas 16 studies used MDRD . Six other studies employed either Jelliffe's equation or a combination of formulas to determine renal function status (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Of the interventional studies (n=21), almost half of them (n=10) were manual supports to physicians in the form of interactive training, education, and feedback by pharmacists or clinical experts . Immediate concurrent feedback given to physicians had brought the highest reduction in IP, ie, from 77% to 19% ( P< .001) (Shown in Figure ).…”

Section: Resultsmentioning

confidence: 99%

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Inappropriate prescribing in chronic kidney disease: A systematic review of prevalence, associated clinical outcomes and impact of interventions

et al. 2017

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Inappropriate prescribing in chronic kidney disease: A systematic review of prevalence, associated clinical outcomes and impact of interventions

et al. 2017

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“…Another study conducted in the residents of aged care facilities; it has shown that DRPs were mostly dose-related [28]. Previous studies have shown that CG and MDRD perform better with varied scenarios [29][30][31][32]. However, the study on meropenem found no difference between CG and MDRD [33].…”

Section: Discussionmentioning

confidence: 97%

Variables Impacting GFR Estimation Method for Drug Dosing in Ckd: Artificial Neural Network Prediction Model

AlJASMI

Khan

Sulaiman

et al. 2019

Int J Pharm Pharm Sci

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Objective: This study aimed to measure concordance between different renal function estimates in terms of drug doses and determine the potential significant clinical differences.Methods: Around one hundred and eighty patients (≥ 1 8 y) with chronic kidney disease (CKD) were eligible for inclusion in this study. A pairedproportion cohort design was utilized using an artificial intelligence model. CKD patients refined into those who have drugs adjusted for renal function. For superiority of Cockcroft-Gault (CG) vs. modified diet in renal disease (MDRD) guided with references for concordance or discordance of the two equations and determined the dosing tiers of each drug. Validated artificial neural networks (ANN) was one outcome of interest. Variable impacts and performed reassignments were compared to evaluate the factors that affect the accuracy in estimating the kidney function for a better drug dosing. Results:The best ANN model classified most cases to CG as the best dosing method (79 vs. 72). The probability was 85% and the top performance was slightly above 93%. Creatinine levels and CKD staging were the most important factors in determining the best dosing method of CG versus MDRD. Ideal and actual body weights were second (24%). Whereas drug class or the specific drug was an important third factor (14%).Conclusion: Among many variables that affect the optimal dosing method, the top three are probably CKD staging, weight, and the drug. The contrasting CKD stages from the different methods can be used to recognize patterns, identify and predict the best dosing tactics in CKD patients.

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Clinical pharmacy practice in the care of Chronic Kidney Disease patients: a systematic review

et al. 2019

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Background Clinical pharmacy services have potential to contribute significantly to the multidisciplinary team providing safe, effective and economic care for patients. Given recent practice developments (e.g. polypharmacy reviews and pharmacist prescribing) there is a need to provide a current synthesis of the evidence base for characteristics and outcomes of clinical pharmacy practice in chronic kidney disease patients. Aim of the review To critically appraise, synthesise and present the available evidence of the characteristics (structures and processes) and outcomes of clinical pharmacy practice as part of the multidisciplinary care of patients with chronic kidney disease. Method PubMed, International Pharmaceutical Abstracts (IPA), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline and Scopus were searched for peer reviewed papers using improved search strategy. Included studies were quality assessed using Downs and Black tool for controlled studies and the mixed methods appraisal tool for all controlled and non-controlled studies. Data were extracted and synthesised using a narrative approach. Screening, quality assessment and data extraction were performed by two independent researchers. Ethics approval was not required. Results Forty-seven studies were identified from a variety of countries, with 31 based in a hospital setting. Controlled study designs were employed in 20, with only ten of these using randomisation. Resources available for service provision were poorly reported in all papers. Positive impact on clinical outcomes included significant improvement in parathyroid hormone, blood pressure, haemoglobin and creatinine clearance. Pharmacists identified 5302 drug related problems in 2933 patients and made 3160 recommendations with acceptance rates up to 95%. Impact on humanistic outcomes was shown through improvement in health related quality of life and patient satisfaction. Economic benefits arose from significant cost savings through pharmaceutical care provision. Conclusion While there is some evidence of positive impact on clinical, humanistic and economic outcomes, this evidence is generally of low quality and insufficient volume. While the existing evidence is in favour of pharmacists’ involvement in the multidisciplinary team providing care to patients with chronic kidney disease, more high-quality research is warranted. Electronic supplementary material The online version of this article (10.1007/s11096-019-00816-4) contains supplementary material, which is available to authorized users.

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Community pharmacist intervention in patients with renal impairment

Abstract: Community pharmacists identified 40 % of DRP related to CKD prescriptions, leading to prescription modification by GPs in a third of the cases. These interventions are likely to decrease drug-related morbidity and mortality.

Cited by 20 publications

References 16 publications

Inappropriate prescribing in chronic kidney disease: A systematic review of prevalence, associated clinical outcomes and impact of interventions

Inappropriate prescribing in chronic kidney disease: A systematic review of prevalence, associated clinical outcomes and impact of interventions

Variables Impacting GFR Estimation Method for Drug Dosing in Ckd: Artificial Neural Network Prediction Model

Clinical pharmacy practice in the care of Chronic Kidney Disease patients: a systematic review

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