The delicate balance of keeping it all together: Using social capital to manage multiple medications for patients on dialysis

Parker, Wendy M.; Ferreira, Kristine; Vernon, Lauren L.; Cardone, Katie E.

doi:10.1016/j.sapharm.2016.07.008

Cited by 11 publications

(26 citation statements)

References 10 publications

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“…One of the studies 16 explored self-management of medication from the perspective of patients on dialysis. The findings show that the use of multiple medications and the weekly routine of three dialysis sessions are barriers to adherence to prescribed medication and carers and family members play an important role in adherence to medication regimens.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Envolvimento da pessoa com doença renal crônica em seus cuidados: revisão integrativa

Almeida

Santos

Rehem

et al. 2019

Ciênc. saúde coletiva

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Resumo A doença renal crônica (DRC) acarreta ao indivíduo uma sobrecarga de cuidados indispensáveis ao alcance das metas terapêuticas e qualidade de vida. O controle nutricional, o regime medicamentoso e as terapias de substituição renal são exemplos que requerem participação ativa. Assim, foi realizada revisão integrativa de artigos científicos para identificar os que versam sobre envolvimento e participação do paciente em seus cuidados na DRC. Os descritores “Chronic kidney disease”; “Self-Care” and “Patient Participation” foram aplicados nas bases CINHAL, Bireme e Medline. Selecionamos 21 publicações entre 2012 e 2016. A entrevista semiestruturada destacou-se como método de coleta de dados, com a aplicação da análise temática fenomenológica. Conforme a predominância do assunto tratado, os manuscritos foram alocados em quatro eixos temáticos: Manejo da doença renal e seu tratamento; Envolvimento na tomada de decisão; Plano avançado de cuidados; e, Diálise peritoneal domiciliar. Verificamos que abordagens envolvendo pessoas transplantadas ou nos primeiros estágios da doença são pouco explorados com a aplicação do método qualitativo e, ainda, consideramos que pessoas com DRC devem ser instigadas no envolvimento ativo de seus próprios cuidados, necessitando de conhecimento, motivação e suporte dos profissionais de saúde.

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Section: Discussionmentioning

confidence: 99%

“…According to patients, exercising while on dialysis is considered less important than dialysis itself and requires encouragement and support from the health team and dialysis service. This perception was shown to be a barrier to intradialytic exercise 16 .…”

Section: Discussionmentioning

confidence: 99%

Envolvimento da pessoa com doença renal crônica em seus cuidados: revisão integrativa

Almeida

Santos

Rehem

et al. 2019

Ciênc. saúde coletiva

View full text Add to dashboard Cite

show abstract

“…We created a tool to assess medication literacy (MedLitD) 36 and compared our results to those of other common health literacy assessments. While health literacy has been more directly tied to formal education, medication literacy and medication management success could require a slightly different set of skills 42 . We have shown that patients with CKD who are better educated, and who have more social capital are able to balance the competing demands of the complex medication and treatment regimen and successfully manage their disease.…”

Section: Misalignment Of Expectations With Abilitiesmentioning

confidence: 99%

“…43 Examples of medication therapy problems are listed in Table 1 Several years ago, our research group completed a multiphase study at three outpatient dialysis centers with patient interviews and staff focus groups to better understand medication needs in dialysis centers. 42,49 Dialysis staff supported the integration of medication management services within dialysis care and identified pharmacists as uniquely qualified to perform these duties. Additionally, there was a clear demonstration of need for patient education and individualized medication reviews that are fully covered by insurance.…”

Section: Medication Reviewmentioning

confidence: 99%

Medication management in dialysis: Barriers and strategies

Cardone

Parker

2020

Seminars in Dialysis

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People with end-stage kidney disease (ESKD) who require chronic dialysis are often reliant on complicated medication regimens to manage their health conditions. Due to the complexities of the advanced kidney disease, underlying comorbidities, and special instructions, medication regimens for patients on dialysis put patients at high risk for medication therapy problems related to safety, effectiveness, appropriateness, and adherence. This article explores the factors that affect optimal medication use for people on dialysis, including the broader drug use system, and offers recommendations around medication reconciliation, medication review, deprescribing, and considering social determinants of health to improve medication management among patients with ESKD.

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“…As highly successful, novel models of interprofessional practice are supported by the Advancing American Kidney Health initiative, these teams should engage CMS in dialog about the body of evidence showing improved patient outcomes. Patients should also be engaged throughout the process with a focus on their satisfaction with CMM services and quality of life 68 . The “bottom‐up” approach allows for frontline pharmacists to provide much greater input to the development of successful interprofessional models and be viewed as a truly value‐added component of the team.…”

Section: Next Stepsmentioning

confidence: 99%

Nephrology practice and research network opinion paper: Pharmacists' perspectives on the Advancing American Kidney Health initiative

Meaney

Manley²,

Pai

et al. 2020

J Am Coll Clin Pharm

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Patients with chronic kidney disease (CKD) are at high risk for clinically significant medication therapy problems (MTPs) due primarily to the complex pharmacotherapy prescribed by numerous providers, and the significant changes in pharmacokinetic and pharmacodynamic properties of many medications due to their kidney disease. While MTPs are well recognized, pharmacists are not routinely involved in the health care teams that provide care for patients with CKD. The Advancing American Kidney Health initiative was announced in July 2019 and is poised to shift models of care in nephrology toward value‐based payment. This represents an opportunity for pharmacists to integrate into teams to improve quality of care and outcomes for patients with CKD. Pharmacists should engage in medication reconciliation, transitions of care, and medication‐focused kidney disease education programs within a comprehensive medication management (CMM) framework to optimize pharmacotherapy outcomes. To implement these services, pharmacists need to utilize certified pharmacy technicians, telehealth, interprofessional skills, and other tools in innovative ways. Current models of successful practice from Canada can serve as a template for United States‐based nephrology pharmacy practice. In this opinion paper, we characterize the current state of nephrology practice and identify significant opportunities for advancement. We propose metrics to evaluate pharmacy services and a framework for key stakeholder engagement which will be critical to advance the profession of pharmacy within nephrology. The Advancing American Kidney Health initiative offers a distinct opportunity to demonstrate the value of CMM provided by pharmacists in the nephrology arena to optimize patient care.

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The delicate balance of keeping it all together: Using social capital to manage multiple medications for patients on dialysis

Cited by 11 publications

References 10 publications

Envolvimento da pessoa com doença renal crônica em seus cuidados: revisão integrativa

Envolvimento da pessoa com doença renal crônica em seus cuidados: revisão integrativa

Medication management in dialysis: Barriers and strategies

Nephrology practice and research network opinion paper: Pharmacists' perspectives on the Advancing American Kidney Health initiative

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