Randomized Trial of Pharmacist Integration in Haemodialysis Teams: Effects on Phosphorus Control and Patient Outcomes

Despite the limited historical engagement of hospital pharmacists in managing blood phosphorus levels, their involvement in this aspect of care for haemodialysis patients remains an underexplored yet potentially promising and effective approach that warrants further investigation.

A prospective, randomized controlled clinical trial was conducted to compare a control group receiving standard care from doctors and nurses with a test group that, in addition to standard care, received medication education and health promotion interventions from pharmacists. This trial is registered at chictr.org.cn, ChiCTR2100044887, and is complete.

The test group demonstrated a significant reduction in blood phosphorus levels (p = 0.0056) and an improvement in blood calcium levels (p = 0.0238), whereas the control group showed no significant changes. The study also identified several potential major epidemiological characteristics for chronic kidney disease, including rural residence (72% of the patients), hypertension (84%), low educational attainment (84%), occupation as farmers or labourers (92%), and low- to middle-income levels (52%). Conversely, factors such as smoking, alcohol consumption, and marital status were not found to be major epidemiological characteristics. The impact of varying health promotion methodologies on biochemical indicators and blood pressure was minimal.

The integration of pharmacists into the clinical team appeared to contribute to the reduction of blood phosphorus levels and healthcare expenditures, highlighting their pivotal role in the cost-effective, multidisciplinary management of haemodialysis patients. This finding underscores the significant economic and clinical importance of considering pharmacists as valuable members of the healthcare team in efforts to optimize patient outcomes.