Savannah Roberts, Pharm.D.

Most providers and clinical staff are not utilizing pharmacists to their full potential – and missing a prime opportunity to help their patients achieve better outcomes.

One of the greatest benefits pharmacists can provide is medication management support. Patients experience better outcomes when they follow medication regimens as prescribed. Unfortunately, many patients struggle with medication adherence. In fact, medication adherence issues contribute to one-half of hospitalizations for dialysis patients¹. Nephrologists, other physicians and dialysis clinic staff work with patients to address medication problems, but they sometimes forget to tap into an invaluable medication management resource – pharmacists.

Pharmacist intervention can help patients understand the importance of adhering to their medications, improve their lab results and reduce the risk of hospitalization.

Here are five ways FreseniusRx pharmacists support patients and dialysis care teams:

1. Answer questions in real time. Many ESRD patients face other health challenges in addition to renal disease, and they often have questions about their illnesses. Instead of scheduling yet another doctor’s appointment, patients can call FreseniusRx and speak with an ESRD-certified pharmacist. In addition to answering questions about medication dosages and side effects, our pharmacists also listen to patients for signs of depression, anxiety or other illnesses, and intervene to improve the patient’s overall health.

2. Interpret lab values as they relate to medications. Many of the lab values used to evaluate dialysis patients tie back to the medications they are taking. Pharmacists can work directly with nephrologists and clinic staff to recommend dosage adjustments or alternative medications that may help the patient experience better health outcomes. Studies show this level of intervention makes a difference – within 9 months after enrollment, FreseniusRx patients experienced a 9 percent improvement in their target ranges for blood calcium, phosphorus and intact parathyroid hormone goals, compared to patients who were not using FreseniusRx².

3. Assist with antibiotic selection and dosing. Some patients may experience an infection at some point. Clinic staff at Fresenius Kidney Care clinics can draw a patient’s blood to test for potential infection and provide treatment at the clinic, reducing the need for hospitalization. FreseniusRx is piloting a program in which our pharmacists provide antibiotic recommendations to clinicians to ensure that the most appropriate antibiotics are selected. Pharmacist involvement in antibiotic selection helps prevent the development of drug-resistant bacteria and ensures patients only receive the minimum necessary exposure to antibiotics to resolve their infection.

4. Provide comprehensive medication management. Through our medication adherence programs, FreseniusRx has already seen improved refill rates from patients, simply by connecting with them once a month by phone. However, we take medication management a step further by also providing physicians and clinic staff with direct access to a pharmacist who will help design a medication regimen that sets up patients for optimal outcomes.

5. Specialize in renal disease and dialysis medications. FreseniusRx pharmacists have a holistic understanding of how other chronic conditions impact a patient’s renal care. We provide recommendations to physicians to ensure that medications prescribed for other conditions – like diabetes and congestive heart failure – are the most optimal choices and dosed appropriately for their patient’s renal function.

 

Medication management requires coordination across a patient’s entire care team – make sure you’re involving the pharmacist, your patient’s personal medication advisor, to contribute to better health outcomes.

Have more questions about pharmacist intervention? Contact us today to learn more.

 

¹Cardone KE, Bacchus S, Assimon MM, et al. Medication-related problems in CKD. Adv Chronic Kidney Dis. 2010;17(5):404-412.

²Rosen S, Larkin J, Thekkumkattil J, Brownlee N, Roberts S, Usvyat L, Hymes J, Ketchersid T, Maddux FW. A renal pharmacy coordinated care program is associated with improvements in bone mineral metabolism outcomes in hemodialysis patients [NKF poster abstract submission #100]. Am J Kidney Dis. 2016.