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Adaptability of clinical pharmacist led interventions in the management of anemia of chronic renal disease: optimizing care
Girish B S
Srinivasan R
Joel M. Johns
C S Meghana
Abstrakt
Renal anemia is a common comorbidity in chronic kidney disease (CKD) patients, typically treated with erythropoiesis-stimulating agents (ESAs) like erythropoietin. However, both over- and under-treatment are prevalent. In 2008, the Pharmacy Council of India introduced the Pharm.D course to enhance pharmaceutical care in clinical settings. While extensive studies in other countries highlight the benefits of clinical pharmacists' interventions, Indian research on this topic is limited. This prospective randomized controlled trial included CKD patients not on dialysis, with serum creatinine levels of 2-6 mg/dL and hemoglobin (Hb) levels below 12 g/dL. Participants were divided into three subgroups based on baseline Hb levels: < 10 g/dL (Group I), 10-12 g/dL (Group II), and >12 g/dL (Group III). ESAs and iron supplements were adjusted to maintain Hb levels of 10-12 g/dL. Quality of life was assessed using the Short Form Health Survey-36 questionnaire. Out of 448 participants, those in the pharmacist intervention group showed a significant shift towards Group II by the trial's end, compared to the control group. The study demonstrated a significant improvement in quality of life and physical performance, particularly for those in Group II, indicating that maintaining Hb levels at 10-12 g/dL is optimal for Indian CKD patients. This trial exemplifies the profound impact clinical pharmacists can have on patient care, highlighting their crucial role in improving healthcare outcomes through active participation and targeted interventions in clinical settings.
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