Pharmaceutical Care in Kidney Transplant Recipients: Behavioral and Physiologic Outcomes at 12 Months

Xu, Xin; Feng, Yu-Tung; Tian, Ye; Wang, H.Y.

doi:10.1016/j.transproceed.2018.04.049

Cited by 6 publications

(12 citation statements)

References 15 publications

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“…Hospital readmission rate was n = 19 (26%) in the intervention group and n = 18 (26%) in the control group ( p = 0.95). No difference in achievement of goals for BP, haemoglobin, phosphorus, or parathyroid hormone Xu et al (2018) Taiwan [ 58 ] Non-randomised, controlled study (12 months) Kidney transplant clinics of a medical centre. To evaluate the behavioural and physiological outcomes of pharmaceutical care in kidney transplant recipients 43 Tx patients RE group 48.6 (8.9).…”

Section: Resultsmentioning

confidence: 99%

“…[ 37 , 43 ] Development of protocols and compiling and updating guidelines were also described in two studies [ 22 , 34 ]. Performing medication reconciliation [ 46 ]; providing patient medication counselling, education on disease status or medication, conducting motivational interviews to improve adherence were also reported [ 15 , 25 , 27 , 29 , 30 , 34 , 36 , 37 , 42 , 43 , 47 – 50 , 55 , 57 , 58 , 60 ]. A number of studies reported pharmacists’ participation in ward rounds [ 17 , 22 , 35 , 37 , 38 , 40 ], providing educational sessions to healthcare professionals [ 22 , 34 ] and performing activities such as medication use evaluations [ 34 ].…”

Section: Resultsmentioning

confidence: 99%

“…Pharmacists were also involved in the monitoring of kidney function in patients with CKD and demonstrated significant differences in measuring CrCl between discharge and admission [ 36 ]. However, one study demonstrated no difference in the mean serum creatinine or estimated glomerular filtration rate (eGFR) between the intervention and control groups [ 58 ]. A retrospective controlled study reported improvement in eGFR, uric acid, cholesterol and HbA1c in the intervention group compared to the control group after multidisciplinary care, however, pharmacists’ contribution to the care was not clearly reported [ 61 ].…”

Section: Resultsmentioning

confidence: 99%

“…Patient satisfaction reported in two randomised controlled studies: 92% of patients had positive feelings about pharmacists’ involvement in their care and felt that the pharmacist provided beneficial information [ 15 ] and 43% of patients were ‘very satisfied’ with the care received and were willing to receive future care from the pharmacist [ 45 ]. A cross-sectional prospective study demonstrated that patients were greatly satisfied with the intervention [ 58 ].…”

Section: Resultsmentioning

confidence: 99%

“…The majority of the 20 controlled studies were of ‘fair’ quality with the exception of four that were considered ‘weak’ [ 22 , 55 , 56 , 58 ]. High quality RCTs with low levels of bias generate the highest level of evidence [ 62 ].…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

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

et al. 2019

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The impact of pharmacist‐led interventions on blood pressure control among patients with chronic kidney disease: A randomized controlled trial

Okoro

Umate

Ohieku

et al. 2022

J Am Coll Clin Pharm

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Introduction Only about 50% of patients with high blood pressure (BP) and chronic kidney disease (CKD) comorbidity have their BP controlled. Objectives The objectives of the study were to determine whether pharmacist‐led interventions reduce mean BP and improve BP control in hypertensive patients with CKD compared with usual care. Methods This 12‐month prospective, double‐blind, randomized, controlled trial was conducted at two major hospitals in Nigeria. Seventy‐four participants were randomized to the usual care arm serving as the control and 73 participants were randomized to the intervention arm. The intervention arm received home BP monitors, and pharmacological and nonpharmacological (education and training on self‐management of CKD and hypertension, and text messages) interventions. Results Baseline characteristics were similar between the intervention (n = 73) and usual care (n = 74) participants. However, significantly more females were in the intervention arm compared with the usual care arm (71.2% vs 52.7%; P = .021). Compared with the usual care arm, systolic BP (SBP) significantly decreased by 7.12 mmHg from baseline (P = .020) in the intervention arm. Higher proportions of patients gained BP control from baseline to 6 months (27.4% vs 13.5%, P = .095), and from baseline to 12 months (20.5% vs 8.1%, P = .096) in the intervention arm than the usual care. There were no statistical differences, but clinical differences were observed. Conclusion This trial demonstrates that including a clinical pharmacist in a team care setting can improve BP reduction and control in patients with CKD and hypertension. Trial registration http://clinicaltrials.gov NCT05254392.

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Chronic Medical Conditions:

Whiteson¹,

Cohen²,

Prilik³

2021

Braddom's Physical Medicine and Rehabilitation

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Pharmaceutical Care in Kidney Transplant Recipients: Behavioral and Physiologic Outcomes at 12 Months

Cited by 6 publications

References 15 publications

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

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

The impact of pharmacist‐led interventions on blood pressure control among patients with chronic kidney disease: A randomized controlled trial

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