The Effect of Pharmacist-Led Educational Intervention on Anaemia Management in Patients with Established Chronic Kidney Disease

OBJECTIVES: Patients with chronic kidney disease (CKD) commonly face multiple comorbidities, including the prevalent of anaemia. The proactive engagement of pharmacists in managing anaemia in CKD patients shows significant potential, especially in countries like Pakistan, where the prevalence of CKD is high, emphasizing the need for effective interventions. The study evaluated the influence of a pharmacist-led educational intervention in alleviating suboptimal anaemia treatment and improving overall outcomes in established CKD patients.

METHODS: The study conducted at Sandeman Provincial Hospital, Quetta, Pakistan, from November 1, 2020, to May 30, 2021, this study utilized a comparative pre- and post-intervention approach. The pre-intervention phase involved 303 CKD patients (stage 3 and above), with 309 in the post-intervention phase. A follow-up three months later included Hb reports. Identification of drug therapy problems (DTP) and anaemia management followed criteria from Cipolle et al. and KDIGO guidelines. Pharmacist-led interventions, involving presentations and reminders, aimed to optimize anaemia management in established CKD patients

RESULTS: In both phases, patients showed no significant differences in sociodemographic and clinical characteristics. In the both phase, 75.9% patients experienced anaemia, receiving a median of 8 drugs (range: 3–15) totalling 2265 and 2397 prescriptions in both phases respectively. The study witnessed a noteworthy decrease in the need for additional drug therapy from 37.6% (114 cases) to 28.2% (87 cases, p-value=0.007). Anti-anaemic drug prescriptions significantly rose from 55.4% to 67.0% (p-value=0.004). Follow-up in the pre-intervention phase indicated a significant decline in anaemia management (10.8% to 6.6%, p-value=0.004), while in the post-intervention phase there was statistically significantly improvement in treatment outcomes (15.4% to 24.3%, p-value=<0.001)

CONCLUSIONS: The intervention significantly reduced DTP and improved treatment outcomes. This underscores the potential of pharmacist involvement in enhancing anaemia management in CKD patients, emphasizing the valuable impact of educational interventions in optimizing healthcare practices for this population