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Evaluation of a chronic kidney disease risk assessment service in community pharmacies
Author(s) -
Gheewala Pankti A,
Peterson Gregory M,
Zaidi Syed Tabish R,
Jose Matthew D,
Castelino Ronald L
Publication year - 2019
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13247
Subject(s) - medicine , referral , kidney disease , pharmacy , renal function , family medicine , risk assessment , risk factor , computer security , computer science
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.