Allowing community pharmacists to order tests & view results speeds disease management: new research – January 27, 2016

Recent research published in the Canadian Pharmacists Journal reveals pharmacist screening of patients deemed ‘at-risk’ of chronic kidney disease (CKD) revealed unrecognised disease in more than 15 per cent of patients tested.

An article published in Pharmacy Daily on Tuesday, January 19, 2016 cites the “research is claimed to be one of the first studies to provide concrete evidence of the benefits associated with allowing community pharmacists to order laboratory tests and see patients’ test results”.1

The Canadian Pharmacists Journal defines CKD as ‘a reduction in kidney function or markers of kidney damage or abnormalities in urine sediment or renal imaging’ and reports more than 1-in-10 people living in Canada have been diagnosed with CKD, and living with the disease for more than three months.2

CKD can lead to increased cardiovascular disease risk and multiple associated illnesses. Due to the amount of harm CKD can cause to the body, regular follow up visits to medical practitioners are required to help people living with CKD manage their disease.

According to the report,”early detection can help optimise the treatment, prevent or slow the progression of the disease, and improve quality of life of patients with CKD. Early stages of CKD are often asymptomatic, making preventative efforts difficult.”2

Therefore, by allowing pharmacists to order tests and review their results, the next steps in disease management may be determined faster regarding treatment and lifestyle adjustments required.

Fifty-five community pharmacies located throughout Alberta, Canada, and 720 patients participated in the study, which tested an online tool called the ‘CKD Pathway.’

The tool, developed by a team of stakeholders including nephrologists, pharmacists, primary care physicians, nurses, other health care professionals, information technology specialists, web developers and designers, was designed to aid in the diagnosis, management and referral of adults living with CKD.2

Notably, 57 per cent of the study participants were male, with a median age of 63. More than a quarter of participants were smokers, 79 per cent of whom had been diagnosed with diabetes. Among the participants, 60 per cent were aware of CKD, with more than three-quarters of this group already diagnosed as the result of a previous laboratory conformation.2

The remaining 18 per cent of study participants were categorised into self-report and/or pharmacist knowledge of their diagnoses.

A total of 113 participants had no knowledge of CKD, or a previous diagnosis, while the remaining 8 per cent had abnormal results.2

By using the CDK Pathway test, pharmacists determined 113 participants with no previous diagnosis of CDK were at high risk for cardiovascular events, as well as kidney dysfunction. The results of the participants aware of their disease cited they had no physician diagnosis of CKD prior to the study.

Allowing pharmacists to examine patients for CKD and access test results will increase the early detection of this disease. Should individuals fit the criteria; pharmacists can determine the next step the individual should take to improve their health and wellbeing.

Given the findings of this study, what are your thoughts on pharmacists being given the opportunity to examine and access test results for CKD?

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1 Pharmacy Daily, January 19, 2016 http://bit.ly/1KpXAjd.

2 Canadian Pharmacists Journal, December 2, 2015 http://bit.ly/1PDWfqC.