A pharmacy medication alert system based on renal function in older patients.

Area of Science:

• Pharmacology
• Nephrology
• Primary Care Medicine

Background:

• Older patients with diabetes or cardiovascular disease are at risk of reduced renal function.
• Current prescription alerts for chronic kidney disease are often ignored by general practitioners (GPs).
• A pharmacy medication alert system (PMAS) could help pharmacists advise GPs on optimizing medications for renal function.

Purpose of the Study:

• To evaluate the therapeutic advice generated by pharmacists using a PMAS.
• To assess medication optimization for patients aged 70+ with diabetes or cardiovascular disease based on renal function.

Main Methods:

• An observational study was conducted in primary healthcare settings in the Netherlands.
• Pharmacists utilized a PMAS to assess medications for older patients with specific comorbidities and reduced renal function.
• GPs considered the clinical context before agreeing with pharmacist recommendations.

Main Results:

• Pharmacists provided 143 therapeutic recommendations for 1333 target drugs across 650 patients.
• This represented 11% of target drugs and involved 13.7% of the study population.
• GPs immediately agreed with 71 recommendations (8.0% of the total population).

Conclusions:

• Pharmacy medication alert systems can generate therapeutic advice for medication optimization in at-risk patients.
• GPs accepted approximately half of the pharmacist-generated advice after evaluating individual patient clinical context.
• The study highlights the potential for pharmacist-led interventions to improve medication management in patients with declining renal function.