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Effectiveness of pharmacist intervention model for chronic kidney disease patients; a prospective comparative study

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Abstract

Background Chronic Kidney Disease (CKD) is a global health concern with profound risk of cardiovascular disease, end stage renal failure and early mortality. Pharmacists’ interventions during chronic disease management have been promising. However, evidence of pharmacist`s involvement in chronic kidney dosease is limited, particularly in developing countries. Objective To implement and evaluate the impact of pharmacist led intervention among pre-dialysis CKD patients. Setting Nephrology outpatient department of tertiary healthcare hospital. Methods Patients with chronic kidney disease from stage 2 to 4 attending hospital between October to December 2018 were enrolled in a multi-arm pre-post prospective study. Pharmacist interventional model consisted of disease education, dietary recommendations, counseling to improve medication adherence along with telephonic follow-up. Interventional group received pharmacist interventional model; whereas control group only received the usual care. The impact of pharmacist`s involvements were evaluated by observing the improvements in knowledge and adherence scores, physiological profile and body composition analysis assessed by body composition monitor (BF-508®) at the end of follow-up of 3 months. Both intervention and control groups were compared by appropriate statistical techniques. Main outcome measure Knowledge and adherence scores, physiological profile and body composition analysis Results Total 120 patients (60 in each group) completed the study. Baseline variables were comparable between the two groups. Pharmacist interventional model causes significant improvement in knowledge score upon follow up between intervention and control groups (19.10 ± 3.65 versus 17.57 ± 3.55, p = 0.022). Likewise, Medication adherence score of intervention group significantly improved as compared to control group (p < 0.05) following the implementation of pharmacist intervention model. Physiological analysis showed small improvements in the intervention group but were not significant. Body composition analysis revealed higher body and visceral fat in both groups at the end of follow up. Conclusion Our analysis underscored that the tested pharmacist interventional model is an effective tool in improving disease knowledge and medication adherence among patients with chronic kideney disease.

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References

  1. Jha V, Garcia-Garcia G, Iseki K, Li Z, Naicker S, Plattner B, Saran R, Wang AY-M, Yang C-W. Chronic kidney disease: global dimension and perspectives. The Lancet. 2013;382(9888):260–72.

    Article  Google Scholar 

  2. Webster AC, Nagler EV, Morton RL, Masson P. Chronic kidney disease. The Lancet. 2017;389(10075):1238–52.

    Article  Google Scholar 

  3. Ullah K, Butt G, Masroor I, Kanwal K, Kifayat F. Epidemiology of chronic kidney disease in a Pakistani population. Saudi J Kidney Dis Transplant. 2015;26(6):1307.

  4. Jessani S, Bux R, Jafar TH. Prevalence, determinants, and management of chronic kidney disease in Karachi, Pakistan-a community based cross-sectional study. BMC Nephrol. 2014;15(1):90.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Tamizuddin S, Ahmed W. Knowledge, attitude and practices regarding chronic kidney disease and estimated GFR in a tertiary care hospital in Pakistan. JPMA J Pak Med Assoc. 2010;60(5):342.

    PubMed  Google Scholar 

  6. Plantinga LC, Tuot DS, Powe NR. Awareness of chronic kidney disease among patients and providers. Adv Chronic Kidney Dis. 2010;17(3):225–36.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Tuot DS, Plantinga LC, Hsu C, Jordan R, Burrows NR, Hedgeman E, Yee J, Saran R, Powe NR, Centers for Disease Control Chronic Kidney Disease Surveillance Team. Chronic kidney disease awareness among individuals with clinical markers of kidney dysfunction. Clin J Am Soc Nephrol. 2011;6(8):1838–44.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Levey AS, Josef C. Chronic kidney disease. The lancet. 2012;379(9811):165–80.

    Article  Google Scholar 

  9. Park J, Ahmadi S-F, Streja E, Molnar MZ, Flegal KM, Gillen D, Kovesdy CP, Kamyar K-Z. Obesity paradox in end-stage kidney disease patients. Prog Cardiovasc Dis. 2014;56(4):415–25.

    Article  PubMed  Google Scholar 

  10. Stemer G, Lemmens-Gruber R. Clinical pharmacy activities in chronic kidney disease and end-stage renal disease patients: a systematic literature review. BMC Nephrol. 2011;12(1):35.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Jha V. Current status of end-stage renal disease care in India and Pakistan. Kidney International Supplements. 2013;3(2):157–60.

    Article  Google Scholar 

  12. Cabello-Muriel A, Gascón–Cánovas JJ, Urbieta-Sanz E, Iniesta-Navalón C. Effectiveness of pharmacist intervention in patients with chronic kidney disease. Int J Clin Pharm. 2014;36(5):896–903.

  13. Rani NV, Soundararajan P, Samyuktha CHL, Kannan G, Thennarasu P. Impact of clinical pharmacist provided education on medication knowledge and adherence of hemodialysis patients in a South Indian University Hospital. Asian J Pharm. Clin Res. 2013;6(4):24–7.

    Google Scholar 

  14. Ghimirey A, Sapkota B, Shrestha S, Basnet N, Shankar PR, Sapkota S. Evaluation of pharmacist counseling in improving knowledge, attitude, and practice in chronic kidney disease patients. SAGE Open Med. 2013;1:2050312113516111.

  15. Cooney D, Moon H, Liu Y, Miller RT, Perzynski A, Watts B, Drawz PE. A pharmacist based intervention to improve the care of patients with CKD: a pragmatic, randomized, controlled trial. BMC Nephrol. 2015;16(1):56.

  16. De Lusignan S, Chan T, Gallagher H, Van Vlymen J, Thomas N, Jain N, Tahir A, et al. Chronic kidney disease management in southeast England: a preliminary cross-sectional report from the QICKD-Quality Improvement in Chronic Kidney Disease Study. Prim Care Cardiovasc J. 2009;2:33–9.

  17. Engelgau MM, El-Saharty S, Kudesia P, Rajan V, Rosenhouse S, Okamoto K. Capitalizing on the demographic transition: tackling noncommunicable diseases in South Asia. 2011: The World Bank.

  18. Chen S-H, Tsai Y-F, Sun C-Y, Wu I-W, Lee C-C, Wu M-S. The impact of self-management support on the progression of chronic kidney disease—a prospective randomized controlled trial. Nephrol Dial Transplant. 2011;26(11):3560–6.

  19. Choi ES, Lee J. Effects of a face-to-face self-management program on knowledge, self-care practice and kidney function in patients with chronic kidney disease before the renal replacement therapy. J Korean Acad Nurs. 2012;42(7):1070–8.

    Article  PubMed  Google Scholar 

  20. Hsieh C-F, Huang S-L, Chen C-L, Chen W-T, Chang H-C, Wu M-L, Yang C-C. Increased risk of chronic kidney disease among users of non-prescribed Chinese herbal medicine in Taiwan. Prev Med. 2012;55(2):155–9.

  21. Tangkiatkumjai M, Boardman H, Praditpornsilpa K, Walker DM. Prevalence of herbal and dietary supplement usage in Thai outpatients with chronic kidney disease: a cross-sectional survey. BMC Complement Altern Med. 2013;13(1):153.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Zullig LL, Peterson ED, Bosworth HB. Ingredients of successful interventions to improve medication adherence. JAMA. 2013;310(24):2611–2.

    Article  CAS  PubMed  Google Scholar 

  23. Park H-M, Lee H-S. Effects of empowerment education program for hemodialysis patients on self-efficacy, self-care agency, self-care activities and physiologic parameters. Korean J Rehabil Nurs. 2010;13(2):151–60.

    Google Scholar 

  24. Paes-Barreto JG, Silva MI, Qureshi AR, Bregman R, Cervante VF, Carrero JJ, Avesani CM. Can renal nutrition education improve adherence to a low-protein diet in patients with stages 3 to 5 chronic kidney disease? J Renal Nutr. 2013;23(3):164–71.

    Article  Google Scholar 

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Correspondence to Yusra Habib Khan.

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This study was supported by Start-up research grant program from Higher Education Commission (HEC) of Pakistan (Ref. no.: 21-2012/SRGP/R&D/HEC/2018).

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Khokhar, A., Khan, Y.H., Mallhi, T.H. et al. Effectiveness of pharmacist intervention model for chronic kidney disease patients; a prospective comparative study. Int J Clin Pharm 42, 625–634 (2020). https://doi.org/10.1007/s11096-020-00982-w

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