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Redefining Medication Management in Dialysis: A Kidney Pharmacy Quality Pyramid.

John Wigneswaran¹, Wendy L St Peter², Allen R Nissenson³

¹Express Scripts, Inc, Franklin Lakes, NJ.

Kidney Medicine

|August 1, 2020

Summary

Managing medications for dialysis patients is complex. A kidney pharmacy-focused quality pyramid can guide optimal medication management, improving patient outcomes and potentially reducing costs.

Keywords:

end-stage renal disease medication management pharmacy

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Area of Science:

Nephrology
Pharmacology
Health Services Research

Background:

Patients with end-stage renal disease (ESRD) on dialysis face high risks of medication-related problems due to complex drug regimens.
Current medication management metrics may not adequately address the unique needs of dialysis patients.
There is a growing emphasis on patient-centered, value-based care, highlighting the need for improved medication management.

Purpose of the Study:

To propose a kidney pharmacy-focused quality pyramid for optimizing medication management in dialysis patients.
To provide a framework for dialysis organizations, healthcare providers, and clinicians.
To enhance medication safety and improve patient outcomes in this vulnerable population.

Main Methods:

Development of a quality pyramid framework tailored to kidney pharmacy needs.
Emphasis on core medication management programs: reconciliation, safety initiatives, and medication therapy management for high-risk individuals.
Review of existing evidence on the effectiveness and cost-effectiveness of active medication management strategies.

Main Results:

The proposed pyramid offers a structured approach to medication management for dialysis patients.
Core programs like medication reconciliation and therapy management can improve adherence and reduce medication errors.
Pharmacy-led medication management, though perceived as costly, can be a cost-effective strategy when implemented effectively.

Conclusions:

A kidney pharmacy-focused quality pyramid can guide improved medication management for dialysis patients.
Implementing comprehensive medication management strategies is crucial for enhancing patient safety and outcomes.
Pharmacy-led interventions hold significant potential for cost-effective disease management in ESRD patients on dialysis.