Evaluation of a chronic kidney disease risk assessment service in community pharmacies. Issue 3 (27th February 2019)

• Record Type: Journal Article
• Authors: Gheewala, Pankti A; Peterson, Gregory M; Zaidi, Syed Tabish R; Jose, Matthew D; Castelino, Ronald L
• Is Part Of: Nephrology. Volume 24:Issue 3(2019)
• Page Start: 301
• Page End: 307
• Publication Date: 2019-02-27
• Subjects: chronic kidney disease -- community pharmacy -- risk assessment -- screening; Nephrology -- Periodicals; Kidneys -- Diseases -- Periodicals; Nephrologists -- Periodicals; 616.61; 616.61
• DOI: 10.1111/nep.13247
• Languages: English
• ISSNs: 1320-5358

Abstract

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 and 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 analyzed 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 optimize the effectiveness of this service. Summary at a Glance: This paper examined the impact of a CKD risk‐assessment service in the community pharmacy setting in Australia, and found fairly suboptimal kidney testing in the at risk‐population, suggesting a significant scope for improvement