Australian Community Pharmacists’ Experience of Implementing a Chronic Kidney Disease Risk Assessment Service

Gheewala, Pankti A.; Peterson, Gregory M.; Zaidi, Syed Tabish Razi; Jose, Matthew; Castelino, Ronald L.

doi:10.5888/pcd15.170485

Cited by 4 publications

(19 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of the 20 included studies, 12 were interviews [7,10,[22][23][24][25][26][27][28][29][30][31], six were focus groups [5,6,8,[32][33][34][35][36], and two were surveys with open-ended responses [9,37] (Table 1). General practitioners, nurses, practice managers, pharmacists and medical assistants were represented across the 20 studies.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…General practitioners, nurses, practice managers, pharmacists and medical assistants were represented across the 20 studies. Included studies were performed in the United Kingdom [6,7,10,22,32], United States [8, 23-26, 28, 29, 33, 34], Australia [5,9,30,36], Canada [27,31,37], and the Netherlands [35].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…The most commonly reported barriers related to detection and management of CKD in primary care were categorised into the 'Environmental context and resources' domain and were reported in 16 studies [5,6,8,9,22,24,[26][27][28][29][30][31][32][33][34][35][36][37]. PC-Ps frequently perceived they lacked time to devote to this task [6,8,9,22,[26][27][28][29][30][31][32][33][34][35] and this was exacerbated by the limited amount of time available for patient appointments. The complex nature of managing multiple co-morbidities also meant additional time was needed for these patients.…”

Section: Environmental Context and Resourcesmentioning

confidence: 99%

“…A lack of clear delineation about the role of PC-Ps in the management of CKD resulted in ambiguities and occasional duplication of tasks such as ordering blood tests [5,7,8,27,29,31,34,36]. Perceptions held by patients about the roles of different healthcare providers was also reported in two studies [8,9,30,34], with one study suggesting that patients could not always differentiate the role of the PC-P compared to nephrologist, and contributed to patient confusion and suboptimal adherence [8,34].…”

Section: Social/professional Role and Identitymentioning

confidence: 99%

“…Barriers related to PC-P perceptions regarding patients were reported in eight studies [5,8,10,28,[30][31][32][33][34]36]. Low patient adherence to management strategies, particularly lifestyle strategies, were reported as a common barrier [5,28,[30][31][32]36]. In addition, PC-P felt that due to the asymptomatic nature of CKD, patients did not understand the seriousness of CKD and were unlikely to prioritise its management until the disease reached a more severe stage with symptoms [8,10,30,33,34].…”

Section: Perceptions About Patientsmentioning

confidence: 99%

See 4 more Smart Citations

Barriers and enablers to detection and management of chronic kidney disease in primary healthcare: a systematic review

2020

View full text Add to dashboard Cite

Background: Chronic kidney disease (CKD) is growing population health concern worldwide, and with early identification and effective management, kidney disease progression can be slowed or prevented. Most patients with risk factors for chronic kidney disease are treated within primary healthcare. Therefore, it is important to understand how best to support primary care providers (PC-P) to detect and manage chronic kidney disease. The aim of this systematic review was to evaluate barriers and enablers to the diagnosis and management of CKD in primary care. Methods: A systematic review of qualitative research on the barriers and/or enablers to detection and/or management of CKD in adults within primary healthcare was conducted. The databases Medline (EBSCO), PubMed, Cochrane CENTRAL, CINAHL (EBSCO) and Joanna Briggs Institute Evidence Based Practice (Ovid) were searched until 27th August 2019. Barriers and/or enablers reported in each study were identified, classified into themes, and categorised according to the Theoretical Domains Framework. Results: A total of 20 studies were included in this review. The most commonly reported barriers related to detection and management of CKD in primary care were categorised into the 'Environmental context and resources' domain (n = 16 studies). Overall, the most common barrier identified was a lack of time (n = 13 studies), followed by a fear of delivering a diagnosis of CKD, and dissatisfaction with CKD guidelines (both n = 10 studies). Overall, the most common enabler identified was the presence of supportive technology to identify and manage CKD (n = 7 studies), followed by the presence of a collaborative relationship between members of the healthcare team (n = 5 studies). Conclusion: This systematic review identified a number of barriers and enablers which PC-P face when identifying and managing CKD. The findings of this review suggest a need for time-efficient strategies that promote collaboration between members of the healthcare team, and practice guidelines which consider the frequently comorbid nature of CKD. Enhanced collaboration between PC-P and nephrology services may also support PC-Ps when diagnosing CKD in primary care, and facilitate improved patient self-management.

show abstract

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Environmental Context and Resourcesmentioning

confidence: 99%

Section: Social/professional Role and Identitymentioning

confidence: 99%

Section: Perceptions About Patientsmentioning

confidence: 99%

See 3 more Smart Citations

Barriers and enablers to detection and management of chronic kidney disease in primary healthcare: a systematic review

2020

View full text Add to dashboard Cite

show abstract

Chronic Kidney Disease Management in Developing Countries

Badro

2023

Handbook of Medical and Health Sciences in Developing Countries

View full text Add to dashboard Cite

Effects of inpatient creatinine testing frequency on acute kidney injury identification and staging: a historical cohort study

Oliveira,

Duarte-Ramos,

Alves da Costa

et al. 2024

Int J Clin Pharm

View full text Add to dashboard Cite

Background Acute kidney injury (AKI) is a multifactorial condition often induced by drugs commonly used in hospitals. Identifying and staging AKI necessitates frequent monitoring of renal function. Aim To assess the impact of real-world hospital practices regarding serum creatinine (SCr) testing on the identification and staging of AKI, and its implications for adjusting drug doses. Method A historical cohort study utilizing hospital records from all adult patients admitted between 01/06/2018 and 31/12/2020 was conducted. Patients with no SCr assessment during their stay or those with an SCr at admission ≥ 2 mg/dL were excluded. AKI was determined using two criteria, namely AKIN and KDIGO, considering the time intervals between two SCr tests as outlined in the criteria. Additionally, patients with SCr increases exceeding AKI limits, regardless the time interval, were also identified. The estimated glomerular filtration rate (eGFR) and kinetic eGFR (KeGFR) were calculated. Results During the study period, 17,269 hospitalizations and 62,255 SCr tests were recorded. Among the 17,032 hospitalizations with a length of stay > 48 h, 46.8% experienced periods with no SCr tests performed for more than 48 h. Any stage of AKI was identified in 7.0% of patients and in 9.1% using AKI and KDIGO criteria, respectively. Ignoring time limits in both criteria revealed potential AKI in 1942 patients (11.2%), indicating a potential underdiagnosis of AKI by 37.5% or 19.1%, depending on the criteria used. A total of 76 drugs requiring dose adjustment in patients with eGFR ≤ 50 ml/min were prescribed in 78.5% admissions. These drugs were prescribed in 87.9% of patients potentially underdiagnosed with AKIN and in 88.9% with KDIGO. Conclusion There is a need for changes in the established hospital procedures to ensure more frequent testing of SCr levels. Implementing an advanced scope of practice for clinical pharmacists could support these changes.

show abstract

Australian Community Pharmacists’ Experience of Implementing a Chronic Kidney Disease Risk Assessment Service

Cited by 4 publications

References 27 publications

Barriers and enablers to detection and management of chronic kidney disease in primary healthcare: a systematic review

Barriers and enablers to detection and management of chronic kidney disease in primary healthcare: a systematic review

Chronic Kidney Disease Management in Developing Countries

Effects of inpatient creatinine testing frequency on acute kidney injury identification and staging: a historical cohort study

Contact Info

Product

Resources

About