Gheewala, PA and Peterson, GM and Zaidi, STR and Jose, MD and Castelino, RL, Evaluation of a chronic kidney disease risk assessment service in community pharmacies, Nephrology pp. 1-16. ISSN 1320-5358 (2018) [Refereed Article]
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Aim: Targeted 'opportunistic' screening might be a sustainable approach for the early detection of people with undiagnosed chronic kidney disease (CKD). The aim of this study was to implement and evaluate a CKD risk assessment service in the community pharmacy setting.
Methods: Twenty-four pharmacies in Tasmania, Australia participated in this study. Targeted people were aged between 50-74 years, with at least one CKD risk factor. The QKidney® risk calculator was used to estimate the participants' 5-year percentage risk of developing moderate-severe CKD. Participants identified with ≥ 3% risk were referred to their general practitioner (GP) and followed-up after 9 months. Laboratory data was collected from a pathology provider. The main outcome measures were rates of GP referral uptake and of participants who underwent estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (ACR) measurement.
Results: We analysed data for 389 screened participants, of whom 203 (52.1%) had ≥ 3% 5-year risk of developing moderate-severe CKD and were referred to their GP. Follow-up was successful for 126 participants and showed low (27%) GP referral uptake. Analysis of the pathology data revealed suboptimal kidney testing in participants with ≥ 3% risk, with eGFR and ACR tests performed for only 52.7% and 25.1% of these participants, respectively.
Conclusions: There is significant scope for improving early detection of CKD via implementation of a community pharmacy-based CKD risk assessment service. However, a healthcare system that encourages inter-professional collaboration between community pharmacists and GPs, and provides a robust referral pathway is needed to optimise the effectiveness of this service.
|Item Type:||Refereed Article|
|Keywords:||kidney disease, screening, community pharmacy, risk assessment|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Pharmacology and pharmaceutical sciences|
|Research Field:||Clinical pharmacy and pharmacy practice|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Gheewala, PA (Miss Pankti Gheewala)|
|UTAS Author:||Peterson, GM (Professor Gregory Peterson)|
|UTAS Author:||Zaidi, STR (Dr Tabish Razi Zaidi)|
|UTAS Author:||Jose, MD (Professor Matthew Jose)|
|UTAS Author:||Castelino, RL (Dr Ronald Castelino)|
|Web of Science® Times Cited:||1|
|Downloads:||48 View Download Statistics|
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