Abstract:
OBJECTIVES: To assess impact of “clinic-based pharmacist’ services on drug adherence and health outcomes in stage 4 or 5 pre-dialysis Chronic Kidney Disease of uncertain etiology (CKDu) patients in an out-patient renal clinic in North Central Province, Sri Lanka. METHODOLOGY: A randomized controlled clinical trial was conducted in Teaching Hospital, Anuradhapura. Demography, drug adherence (using BMQ Score), management outcomes, and Quality of Life (using KDQOL-SF™) were assessed. Intervention(I) group received four counseling sessions by a “clinic-based pharmacist” plus usual clinic care over 12 months. Control (C) group received usual care. RESULTS: Of 256 eligible patients, 127 were allocated to C and 129 to I. Demography and baseline outcome measures were similar. At 12 months, median BMQ scores improved from 5(3-5) to 3(2-4) (p<0.050), mean hemoglobin (Hb) levels improved from 11.02±1.44g/dL to 11.41±1.37g/dL (p<0.050) and QOL improved in I group. In C group, mean diastolic blood pressure and mean serum creatinine increased and eGFR was reduced, but those outcomes were unaltered in I group. CONCLUSION: “Clinic-based pharmacist” services improved drug adherence, Hb levels and QOL in stage 4 or 5 pre-dialysis CKDu patients. This service can improve disease outcomes.
