clinical pharmacist - Malaysian Journal of Pharmacy (MJP)

Evaluation of the Impact of Clinical Pharmacists’ Educational Intervention on the Knowledge of Patients with Chronic Kidney Disease

by Roland Nnaemeka Okoro, Ibrahim Ummate, John David Ohieku, Sani Ibn Yakubu and Maxwell Ogochukwu Adibe.

Vol. 8 No. 2 (2022): Malaysian Journal of Pharmacy / Published: December 31, 2022

Abstract

Introduction: Chronic kidney disease (CKD) is a progressive disease associated with high morbidity and mortality at all stages. Objective: To determine the impact of pharmacists’ educational interventions on the CKD knowledge and knowledge levels of patients with pre-dialysis CKD, and to identify potential predictors of good CKD knowledge. Method: Two main healthcare facilities in Maiduguri, Nigeria, were the study settings for this randomised, controlled, prospective study with a 12-month follow-up. Participants were randomised to the usual care (UC) and pharmacists’ intervention (PI) groups on a 1:1 ratio. The PI group was offered usual care plus face-to-face CKD education and self-management of CKD, an educational CKD infographic leaflet, and telephonic interventions. Categorical data were compared using Chi-square or Fisher exact tests where relevant, while an independent sample T-test was used to compare the mean values of the two study groups. A p-value of less than 0.05 was considered to be statistically significant. Result: Baseline characteristics were similar between the PI (n = 73) and UC (n = 74) patients, although participants in the PI group were significantly more female (71.2% vs. 52.7%; p = 0.021). The overall mean knowledge score of the PI group was significantly higher than the UC group at 6 months (18.9 ± 3.4 vs.14.6 ± 4.4, p < 0.001), and at 12 months (19.5 ± 3.8 vs.16.8 ± 6.0, p < 0.001), respectively. At 6 months, a significant proportion of the participants in the intervention group had high knowledge compared with those in the UC group (16.4% vs. 9.0%, p < 0.001). At the end of the study, the adjusted analysis revealed that those between 40 and 64 years of age (AOR 26.3, 95% CI 2.1 – 331.0) and 65 years of age or more (AOR 10.1 95% CI 1.1 – 89.7) were more likely to have good CKD knowledge. Also, participants in the intervention group (AOR 2.7, 95% CI1.0 – 7.2) had a higher likelihood of having good CKD knowledge. Conclusion: Educational interventions provided by pharmacy students/clinical pharmacists resulted in significant improvements in the CKD knowledge of patients with pre-dialysis CKD.

Impact of Medication Reconciliation by Clinical Pharmacist during Hospital Admission of Patients with Chronic Kidney Disease (CKD) Stage IV-V in Hospital Raub, Pahang

DOI: 10.52494/WDIT9874

by Chen Tze Seong.

Vol. 7 No. 1 (2021): Malaysian Journal of Pharmacy / Published: June 30, 2021

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Abstract

Medication errors are more likely to occur during patient’s transition of care. There was very little information about impact of medication reconciliation activities done for patients with chronic kidney disease (CKD) Stage IV-V during admission stage in Malaysian Primary Hospitals. The objective of this study is to evaluate the impact of clinical pharmacist’s medication reconciliation activities during hospital admission of patients with CKD stage IV-V. This cross-sectional study was carried out in two multidisciplinary wards (male & female ward) in Hospital Raub, Pahang over 12 months with ethical approval. A clinical pharmacist was assigned to enroll potential study subjects in both wards. Patients over 18 years old who had previous history of CKD Stage IV-V were included in the study after obtaining informed consent. Medication reconciliation was carried out by the clinical pharmacist within 24 working hours during the admission of study subjects. All detected medication discrepancies were further classified as “intended” or “unintended” after discussion with the prescribing medical officer. The Severity Level of each unintended medication discrepancy was rated by a visiting medical specialist. Twelve patients with CKD stage V were recruited to the study. A total of 49 medication discrepancies were identified and most (89.8%) were found to be unintended. The most common unintended medication discrepancy identified was omission error. Most of the unintended medication discrepancies (59.1%) was rated as “No potential harm”, while 40.9% were rated as “Potential for monitoring and/or Intervention to preclude harm”. None of the unintended medication discrepancy was rated as “Potential harm”. In conclusion, medication discrepancies were common during admission of patients with late-stage chronic kidney disease in a primary hospital. Medication reconciliation performed by clinical pharmacist during admission has a potential role in preventing potential harms that may arise from unintentional medication discrepancies.