Implementation of clinical pharmacy services in a dialysis unit

Erickson, Abbie; Szumita, Paul M.; Cotugno, Michael

doi:10.2146/ajhp070569

Cited by 6 publications

(3 citation statements)

References 7 publications

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“…Pharmacists are trained to identify MRPs through a structured review of a patient’s medication list and to communicate with physicians to find therapeutic alternatives, or, to deprescribe unnecessary medications in order to reduce polypharmacy [ 13 , 14 , 15 , 16 , 17 , 18 ]. Several studies established the crucial role of pharmacists in identifying MRPs associated with polypharmacy and suggested appropriate interventions to optimize patient outcomes [ 14 , 15 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Polypharmacy and Medication-Related Problems in Hemodialysis Patients: A Call for Deprescribing

et al. 2018

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Polypharmacy is a common problem among hemodialysis patients. It is associated with increased hospital admissions, morbidity, mortality, Medication-Related Problems (MRPs), and expenditures. There is a paucity of data on the prevalence of polypharmacy in our setting. This study aims to determine the prevalence of polypharmacy and MRPs and to assess its predictors. We conducted a cross-sectional study in the outpatient hemodialysis unit. A pharmacy resident assessed electronic prescribing records to identify MRPs and discussed therapeutic interventions to enhance effective therapeutic regimens over a three months period. Eighty-three patients were included. The median age was 63 (Interquartile range; IQR = 22), 50% were males, and the mean number of co-morbidities was 3.14 ± 1.64. The prevalence of polypharmacy was 97.6% with a 95% CI (91.6%–99.7%). Medication use without indication, was the highest identified MRPs at 36% (102/280), followed by subtherapeutic dosing at 23% (65/280), and overdosing at 15% (41/280). The number of comorbidities, the presence of ischemic heart disease, and respiratory diseases were the main predictors of the increased number of medications. Polypharmacy is highly prevalent among the Saudi hemodialysis population. A review of the medications prescribed by the pharmacist facilitated the identification of MRPs and provided opportunities for deprescribing to optimize medication use and to reduce polypharmacy in hemodialysis patients.

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Section: Introductionmentioning

confidence: 99%

Polypharmacy and Medication-Related Problems in Hemodialysis Patients: A Call for Deprescribing

et al. 2018

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“…22 In the second stage, the pool of articles of interest was extracted from the 5 systematic reviews included after deleting duplicates and applying exclusion criteria. A total of 39 articles were included in the final analysis 23-61 (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…Several of the studies included in our work did not report changes in patient health outcomes as a result of the pharmacist intervention but only reported changes in intermediate process measures. 24,32,36,39-43,46-48,50,56,60 Most of these studies were also classified as nonimplementable 39-43,46-48,50,56,60 because all of them described pharmacist-led medication reviews without describing the method of medication review or the drug information sources used. Previous authors have highlighted the need for an evidence-based practice when conducting medication reviews.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Implementability of Clinical Pharmacist Interventions in Patients With Chronic Kidney Disease

et al. 2013

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Effectiveness Evaluation of a Graded Pharmaceutical Care Model in Women with Intrahepatic Cholestasis of Pregnancy: A Before‐After Study

Guo,

Zhang,

Shen

et al. 2024

Journal of Clinical Pharmacy and Therapeutics

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Objective. Intrahepatic cholestasis of pregnancy (ICP) significantly impacts the maternal and fetal safety. Research on the role of clinical pharmacists in guiding drug therapy for this condition remains limited. This study aimed to evaluate the effectiveness of graded pharmaceutical care for women with intrahepatic cholestasis of pregnancy and to provide a theoretical foundation for clinical pharmacist services. Study Design. This study comprises a pre‐and‐post analysis of women with intrahepatic cholestasis of pregnancy (ICP) treated between December 2019 and June 2023 at a tertiary hospital in Jiangsu province. Each group consisted of 102 participants. The control group received standard treatment, while the guardianship group received graded pharmacological care provided by a clinical pharmacist. The effectiveness of pharmacological monitoring by clinical pharmacists was assessed by comparing and analyzing clinical outcome indicators, quality management indicators, safety indicators, and economic factors. Results. The guardianship group exhibited a noteworthy 12.8% reduction in combined adverse pregnancy outcome and more effective management of total prenatal bile acids compared to the control group (16.05 µmol/L vs. 22.85 µmol/L, P < 0.05). The guardianship group displayed superior rationalization of therapeutic drugs and medication duration (P < 0.05). The cost‐benefit analysis revealed a favorable economic impact concerning medication costs but did not indicate economic significance regarding total inpatient costs. Conclusion. The implementation of a graded pharmaceutical care model by a clinical pharmacist holds the potential to enhance outcomes for women experiencing intrahepatic cholestasis during pregnancy, mitigate adverse pregnancy results, optimize the rational utilization of therapeutic medications, and yield positive economic results.

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Implementation of clinical pharmacy services in a dialysis unit

Cited by 6 publications

References 7 publications

Polypharmacy and Medication-Related Problems in Hemodialysis Patients: A Call for Deprescribing

Polypharmacy and Medication-Related Problems in Hemodialysis Patients: A Call for Deprescribing

Assessing the Implementability of Clinical Pharmacist Interventions in Patients With Chronic Kidney Disease

Effectiveness Evaluation of a Graded Pharmaceutical Care Model in Women with Intrahepatic Cholestasis of Pregnancy: A Before‐After Study

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