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Evaluation of a chronic kidney disease risk assessment service in community pharmacies

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Gheewala, PA, Peterson, GM ORCID: 0000-0002-6764-3882, Zaidi, STR ORCID: 0000-0002-2031-1055, Jose, MD ORCID: 0000-0002-9589-0071 and Castelino, RL 2018 , 'Evaluation of a chronic kidney disease risk assessment service in community pharmacies' , Nephrology , doi: 10.1111/nep.13247.

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Abstract

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: Article
Authors/Creators:Gheewala, PA and Peterson, GM and Zaidi, STR and Jose, MD and Castelino, RL
Keywords: kidney disease screening pharmacy
Journal or Publication Title: Nephrology
Publisher: Blackwell Publishing Asia
ISSN: 1320-5358
DOI / ID Number: 10.1111/nep.13247
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