Demonstrating the value of community pharmacists in New Zealand educating a targeted group of people to temporarily discontinue medicines when they are unwell to reduce the risk of acute kidney injury

Int J Pharm Pract. 2020 Dec;28(6):569-578. doi: 10.1111/ijpp.12666. Epub 2020 Sep 17.

Abstract

Objective: Acute kidney injury (AKI) prevention strategies for community-acquired AKI associated with severe acute illness have received attention in recent years. The objective of this study was to evaluate a community pharmacist AKI education programme aimed at patient self-management during acute dehydrating illnesses.

Methods: This was a multimethod study. Potential participants were identified by community pharmacists when they presented a prescription containing a study medicine. The intervention consisted of completion of a short demographic questionnaire and a pharmacist providing verbal AKI information and advice on self-management during acute dehydrating illness, including medicine withholding. This information was supported with take-home information. Participants were telephoned between 4 and 11 months later and invited to participate in a structured telephone interview. Descriptive statistics were generated from questionnaire responses, and interview data were analysed using manifest content analysis.

Key findings: One hundred and thirteen adults were recruited and 93 (82%) interviewed. Fifty-four (58%) interviewees remembered the pharmacist's education, and 51 (55%) had retained the information sheet. Fifty-eight (62%) would temporarily withhold medicines during acute dehydrating illnesses. Thirty-nine were comfortable they knew when to restart their medicines; 15 (38%) indicated this was once symptom-free for 48 h. Forty-six interviewees were comfortable about contacting their general practice; 16 (35%) would do this after 24 h of illness. Participants found the educational content and pharmacist approach acceptable.

Conclusion: A majority of participants accepted and remembered the information provided by their community pharmacist and felt comfortable to self-manage during acute dehydrating illness. A caveat is participant actions in practice may not be consistent with stated intentions.

Keywords: acute kidney injury; community pharmacy services; health education; pharmacists.

MeSH terms

  • Acute Kidney Injury / prevention & control*
  • Adult
  • Aged
  • Aged, 80 and over
  • Community Pharmacy Services / organization & administration*
  • Female
  • Humans
  • Male
  • Middle Aged
  • New Zealand
  • Patient Acceptance of Health Care / statistics & numerical data
  • Patient Education as Topic / methods*
  • Pharmacists / organization & administration*
  • Professional Role
  • Self-Management / methods
  • Surveys and Questionnaires
  • Telephone
  • Withholding Treatment