Lahore College for Women University, Institute of Pharmacy, 54000, Lahore, Pakistan.
Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, 72311, Al-Jouf, Kingdom of Saudi Arabia.
Int J Clin Pharm. 2020 Apr;42(2):625-634. doi: 10.1007/s11096-020-00982-w. Epub 2020 Feb 5.
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 pharmacists 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 pharmacists 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.
慢性肾脏病（CKD）是一个全球性的健康问题，存在心血管疾病、终末期肾衰竭和早期死亡的巨大风险。在慢性病管理中，药师的干预措施已初见成效。然而，在发展中国家，药师参与慢性肾脏病的证据有限。目的：实施并评估以药师为主导的干预措施在透析前慢性肾脏病患者中的应用效果。地点：三级保健医院的肾病门诊。方法：2018 年 10 月至 12 月期间，在医院就诊的 2 至 4 期慢性肾脏病患者被纳入一项多臂前后瞻性研究。药师干预模式包括疾病教育、饮食建议、提高药物依从性的咨询以及电话随访。干预组接受药师干预模式，而对照组仅接受常规护理。通过观察知识和依从性评分、生理参数和身体成分分析（使用身体成分监测仪[BF-508]评估）的改善情况，在 3 个月的随访结束时评估药师参与的效果。采用适当的统计技术比较干预组和对照组的结果。主要观察指标：知识和依从性评分、生理参数和身体成分分析。结果：共有 120 名患者（每组 60 名）完成了研究。两组的基线变量无显著差异。在干预组和对照组中，药师干预模式可显著提高知识评分（干预组：19.10±3.65；对照组：17.57±3.55；p=0.022）。同样，与对照组相比，实施药师干预模式后，干预组的药物依从性评分也显著提高（p<0.05）。生理分析显示干预组有较小的改善，但无统计学意义。身体成分分析显示，两组患者在随访结束时的体脂和内脏脂肪含量均较高。结论：我们的分析表明，经过测试的药师干预模式是提高慢性肾脏病患者疾病知识和药物依从性的有效工具。
