Lisa Zhu1, Andrea Fox2, Yu Chun Chan3. 1. BScPhm, ACPR, PharmD, is a Clinical Pharmacist in the Division of Nephrology, Sunnybrook Health Sciences Centre, Toronto, Ontario. 2. BSc, BScPhm, is a Clinical Pharmacist in the Division of Nephrology, Sunnybrook Health Sciences Centre, Toronto, Ontario. 3. BSc, BScPhm, was, at the time the study was conducted, a pharmacy research student at Sunnybrook Health Sciences Centre, Toronto, Ontario. He is now a Clinical Pharmacist with North York General Hospital, Toronto, Ontario.
Abstract
BACKGROUND: The Kidney Care Clinic at Sunnybrook Health Sciences Centre provides multidisciplinary care for patients with stage 4 or 5 chronic kidney disease. These patients are at high risk of drug therapy problems. Clinic pharmacists review medications and provide recommendations at each visit, but potential gaps in care exist between clinic visits. Community pharmacists are ideally situated to identify and resolve drug therapy problems between visits. OBJECTIVES: To determine community pharmacists' confidence in managing care for patients with chronic kidney disease; to identify opportunities for improving collaboration between clinic and community pharmacists; and to determine the key clinical information that community pharmacists would use when caring for these patients. METHODS: An anonymous survey was sent by mail and electronically to community pharmacies that were providing prescription medications for clinic patients. A total of 318 surveys were sent to 96 pharmacies. Data analysis was based on descriptive statistics, including frequencies, ranges, and measures of central tendency. RESULTS: Fifty-one completed surveys were returned (response rate 16%). Thirty-five (69%) of the responding pharmacists were not aware or were unsure that a patient from the Kidney Care Clinic was a client of their pharmacy. Forty-six (90%) were confident in providing counselling about medications used to manage chronic kidney disease, and 32 (63%) indicated confidence in recommending drug dosing changes based on kidney function. Forty-five (88%) of the pharmacists indicated a willingness to play a greater role in reviewing medications for patients with chronic kidney disease, and all agreed that they would benefit from education about the complications of this disease and their management. Clinical information ranked most useful included an updated medication list with indications and details regarding recent medication changes. CONCLUSIONS: Community pharmacists indicated willingness to have greater involvement in the care of patients with chronic kidney disease. The survey results revealed a need to increase awareness of clinic patients among community providers. Participants were receptive to continuing education, and initial efforts should focus on dosing adjustments of renal drugs and the complications of chronic kidney disease. Tools for transferring clinical information must be developed.
BACKGROUND: The Kidney Care Clinic at Sunnybrook Health Sciences Centre provides multidisciplinary care for patients with stage 4 or 5 chronic kidney disease. These patients are at high risk of drug therapy problems. Clinic pharmacists review medications and provide recommendations at each visit, but potential gaps in care exist between clinic visits. Community pharmacists are ideally situated to identify and resolve drug therapy problems between visits. OBJECTIVES: To determine community pharmacists' confidence in managing care for patients with chronic kidney disease; to identify opportunities for improving collaboration between clinic and community pharmacists; and to determine the key clinical information that community pharmacists would use when caring for these patients. METHODS: An anonymous survey was sent by mail and electronically to community pharmacies that were providing prescription medications for clinic patients. A total of 318 surveys were sent to 96 pharmacies. Data analysis was based on descriptive statistics, including frequencies, ranges, and measures of central tendency. RESULTS: Fifty-one completed surveys were returned (response rate 16%). Thirty-five (69%) of the responding pharmacists were not aware or were unsure that a patient from the Kidney Care Clinic was a client of their pharmacy. Forty-six (90%) were confident in providing counselling about medications used to manage chronic kidney disease, and 32 (63%) indicated confidence in recommending drug dosing changes based on kidney function. Forty-five (88%) of the pharmacists indicated a willingness to play a greater role in reviewing medications for patients with chronic kidney disease, and all agreed that they would benefit from education about the complications of this disease and their management. Clinical information ranked most useful included an updated medication list with indications and details regarding recent medication changes. CONCLUSIONS: Community pharmacists indicated willingness to have greater involvement in the care of patients with chronic kidney disease. The survey results revealed a need to increase awareness of clinic patients among community providers. Participants were receptive to continuing education, and initial efforts should focus on dosing adjustments of renal drugs and the complications of chronic kidney disease. Tools for transferring clinical information must be developed.
Entities:
Keywords:
chronic kidney disease; clinic; collaborative; community pharmacist; pharmaceutical care; seamless care
Authors: Lesley A Stevens; Suying Li; Changchun Wang; Cindy Huang; Bryan N Becker; Andrew S Bomback; Wendy Weinstock Brown; Nilka Ríos Burrows; Claudine T Jurkovitz; Samy I McFarlane; Keith C Norris; Michael Shlipak; Adam T Whaley-Connell; Shu-Cheng Chen; George L Bakris; Peter A McCullough Journal: Am J Kidney Dis Date: 2010-03 Impact factor: 8.860
Authors: Jeffrey C Fink; Jeanine Brown; Van Doren Hsu; Stephen L Seliger; Loreen Walker; Min Zhan Journal: Am J Kidney Dis Date: 2009-02-26 Impact factor: 8.860