Community Pharmacy-Based eGFR Screening for Early Detection of CKD in High Risk Patients
Background: Chronic kidney disease (CKD) is a condition presenting with long-term slow progression of structural and/or functional damage to the kidneys. Early detection is key to preventing complications and improving outcomes. Point-of-care estimated glomerular filtration rate (eGFR) screening tec...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2020-05-01
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| Series: | Canadian Journal of Kidney Health and Disease |
| Online Access: | https://doi.org/10.1177/2054358120922617 |
| _version_ | 1819265693777920000 |
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| author | John Papastergiou Michelle Donnelly Wilson Li Robert D. Sindelar Bart van den Bemt |
| author_facet | John Papastergiou Michelle Donnelly Wilson Li Robert D. Sindelar Bart van den Bemt |
| author_sort | John Papastergiou |
| collection | DOAJ |
| description | Background: Chronic kidney disease (CKD) is a condition presenting with long-term slow progression of structural and/or functional damage to the kidneys. Early detection is key to preventing complications and improving outcomes. Point-of-care estimated glomerular filtration rate (eGFR) screening technology allows for detection of abnormal kidney function in the community pharmacy setting. Objective: To evaluate the effectiveness of a community pharmacist-directed point-of-care screening program and to identify the prevalence of CKD in high-risk patients. Design: Quantitative observational. Setting: Four community pharmacies in British Columbia over a 6-month period. Patients: In all, 642 participants with at least one CKD risk factor were identified and screened. Mean age was 60 years and females accounted for 55% of the study population. Measurements: Serum creatinine was measured from peripheral blood using the HeathTab® screening system (Piccolo® Renal Function Panel with the Piccolo® blood chemistry analyzer). eGFR was calculated according to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. Methods: Patients provided a sample of peripheral blood via a self-administered finger-prick and analytical data to assess kidney function was reported including blood urea nitrogen (BUN), serum creatinine, and electrolytes by the HealthTab ® screening system. Once results were available, the pharmacist conducted a comprehensive medication review with the patient and recommended certain follow-up actions if appropriate. Results: CKD risk factor included diabetes (30%), hypertension (45%), cardiovascular disease (12%), family history of kidney disease (13%), age over 55 years (68%), and an Aboriginal, Asian, South Asian, or African ethnic background (82%). A total of 11.5% of patients had eGFR values lower than 60 mL/min (abnormal renal function) and 34% had an eGFR between 60 and 89 mL/min (minimally reduced renal function). Overall pharmacists’ actions included blood pressure check (98%), education on CKD and risk factors (89%), medication review (72%), and physician follow-up (38%). Limitations included lack of follow-up beyond the 3-month study period prevented medical confirmation of CKD and limited the ability to quantify the impact of pharmacist interventions on the clinical outcomes of patients with low eGFR. Conclusion: These results illustrate the prevalence of abnormal renal function among undiagnosed, high-risk patients in the community. Pharmacists, as the most accessible healthcare practitioners, are ideally positioned to utilize novel point-of care technologies to improve access to CKD screening, facilitate follow-up, and increase awareness around the importance of early detection. |
| first_indexed | 2024-12-23T20:49:26Z |
| format | Article |
| id | doaj.art-0cf8d507e40e4519a1913c824f9af3f6 |
| institution | Directory Open Access Journal |
| issn | 2054-3581 |
| language | English |
| last_indexed | 2024-12-23T20:49:26Z |
| publishDate | 2020-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Canadian Journal of Kidney Health and Disease |
| spelling | doaj.art-0cf8d507e40e4519a1913c824f9af3f62022-12-21T17:31:42ZengSAGE PublishingCanadian Journal of Kidney Health and Disease2054-35812020-05-01710.1177/2054358120922617Community Pharmacy-Based eGFR Screening for Early Detection of CKD in High Risk PatientsJohn Papastergiou0Michelle Donnelly1Wilson Li2Robert D. Sindelar3Bart van den Bemt4School of Pharmacy, University of Waterloo, ON, CanadaUniversity of Toronto, ON, CanadaShoppers Drug Mart, Toronto, ON, CanadaCentre for Health Evaluation & Outcomes Sciences, Providence Health Care Research Institute, The University of British Columbia, Vancouver, CanadaRadboud University Medical Center, Nijmegen, The NetherlandsBackground: Chronic kidney disease (CKD) is a condition presenting with long-term slow progression of structural and/or functional damage to the kidneys. Early detection is key to preventing complications and improving outcomes. Point-of-care estimated glomerular filtration rate (eGFR) screening technology allows for detection of abnormal kidney function in the community pharmacy setting. Objective: To evaluate the effectiveness of a community pharmacist-directed point-of-care screening program and to identify the prevalence of CKD in high-risk patients. Design: Quantitative observational. Setting: Four community pharmacies in British Columbia over a 6-month period. Patients: In all, 642 participants with at least one CKD risk factor were identified and screened. Mean age was 60 years and females accounted for 55% of the study population. Measurements: Serum creatinine was measured from peripheral blood using the HeathTab® screening system (Piccolo® Renal Function Panel with the Piccolo® blood chemistry analyzer). eGFR was calculated according to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. Methods: Patients provided a sample of peripheral blood via a self-administered finger-prick and analytical data to assess kidney function was reported including blood urea nitrogen (BUN), serum creatinine, and electrolytes by the HealthTab ® screening system. Once results were available, the pharmacist conducted a comprehensive medication review with the patient and recommended certain follow-up actions if appropriate. Results: CKD risk factor included diabetes (30%), hypertension (45%), cardiovascular disease (12%), family history of kidney disease (13%), age over 55 years (68%), and an Aboriginal, Asian, South Asian, or African ethnic background (82%). A total of 11.5% of patients had eGFR values lower than 60 mL/min (abnormal renal function) and 34% had an eGFR between 60 and 89 mL/min (minimally reduced renal function). Overall pharmacists’ actions included blood pressure check (98%), education on CKD and risk factors (89%), medication review (72%), and physician follow-up (38%). Limitations included lack of follow-up beyond the 3-month study period prevented medical confirmation of CKD and limited the ability to quantify the impact of pharmacist interventions on the clinical outcomes of patients with low eGFR. Conclusion: These results illustrate the prevalence of abnormal renal function among undiagnosed, high-risk patients in the community. Pharmacists, as the most accessible healthcare practitioners, are ideally positioned to utilize novel point-of care technologies to improve access to CKD screening, facilitate follow-up, and increase awareness around the importance of early detection.https://doi.org/10.1177/2054358120922617 |
| spellingShingle | John Papastergiou Michelle Donnelly Wilson Li Robert D. Sindelar Bart van den Bemt Community Pharmacy-Based eGFR Screening for Early Detection of CKD in High Risk Patients Canadian Journal of Kidney Health and Disease |
| title | Community Pharmacy-Based eGFR Screening for Early Detection of CKD in High Risk Patients |
| title_full | Community Pharmacy-Based eGFR Screening for Early Detection of CKD in High Risk Patients |
| title_fullStr | Community Pharmacy-Based eGFR Screening for Early Detection of CKD in High Risk Patients |
| title_full_unstemmed | Community Pharmacy-Based eGFR Screening for Early Detection of CKD in High Risk Patients |
| title_short | Community Pharmacy-Based eGFR Screening for Early Detection of CKD in High Risk Patients |
| title_sort | community pharmacy based egfr screening for early detection of ckd in high risk patients |
| url | https://doi.org/10.1177/2054358120922617 |
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