Authors (including presenting author) :
Leung PH(1), Hau LM(2), Hau KC(2), Chu LM(1), Yung L(1)
Affiliation :
(1)Department of Pharmacy, Tuen Mun Hospital, (2)Department of Medicine and Geriatrics, Tuen Mun Hospital
Introduction :
Medication non-compliance has been a major problem that led to sub-optimal management of CKD-MBD. Patients with low medication compliance often result in calcium and phosphate imbalance, which could increase the risk of developing renal osteodystrophy and vascular calcification. Previous studies have suggested that pharmacist intervention can optimize drug use in CKD-MBD and improve calcium and phosphate balance. This study targeted to examine whether providing additional telepharmacy follow-up to end stage renal disease patients could confer additional benefits for the management of CKD-MBD.
Objectives :
To evaluate the whether participation into the service model would help improve medication compliance and patient's calcium and phosphate level control
Methodology :
This is a prospective interventional study with historical control. Subjects were recruited by nephrologist referral and received care under a standardized service model. Within the service model, all subjects received a one-off pharmacist consultation, while those with suboptimal disease control or low medication compliance were invited for additional telephone follow-up. Patients were followed for 6 months, and the results were compared with 6 months of historical data.
Result & Outcome :
This study recruited 41 subjects and 22 subjects were invited to receive monthly telephone follow-ups. Patients who participated in this study showed improvement in calcium (-0.11 mmol/L, p=0.002) and phosphate (-0.19 mmol/L, p=0.005) levels between month 0 to 3. Due to the progressive nature of CKD-MBD, a similar but weaker numerical change is observed between month 0 to month 6 (Calcium -.0.08, p=0.014; Phosphate -0.05, p=0.297) There is also an improvement in medication compliance, with a significant decrease in the number of patients who have missed dose due to forgetfulness (-17%, p=0.035) and the number of patients with DRP (-31.8%, p< 0.001).
