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A Scoping Review of Pharmacist-Based Interprofessional Interventions for Management of
Wendy L St Peter1, Joshua J Neumiller2,3, Radica Alicic3
1College of Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA.
Insights
Clinical pharmacists play a key role in managing cardiovascular-kidney-metabolic (CKM) conditions through interprofessional teams. Their involvement improves patient outcomes, but more research is needed on specific CKM health impacts.
Area of Science:
- Pharmacology and Interprofessional Healthcare
- Cardiovascular-Kidney-Metabolic (CKM) Condition Management
Background:
- Co-existing cardiovascular-kidney-metabolic (CKM) conditions are prevalent, necessitating interprofessional care.
- Clinical pharmacists are vital in managing CKM conditions, improving patient access and adherence to guideline-directed medical therapy (GDMT).
Purpose of the Study:
- To explore interprofessional team-based interventions involving pharmacists in managing CKM conditions in the U.S.
- To identify effective pharmacist roles and interventions for patients with co-existing cardiovascular, kidney, and metabolic diseases.
Main Methods:
- A scoping review of studies published between 2015 and 2025 was conducted.
- Searches included Embase and MEDLINE for studies on patients with >5% prevalence of both chronic kidney disease (CKD) and cardiovascular or metabolic conditions.
- Outcomes assessed included kidney function (eGFR, UACR), glycemic control (HbA1c), blood pressure, and patient/physician satisfaction.
Main Results:
- Twenty-eight studies (18 RCTs, 4 pilot, 6 observational) met eligibility criteria.
- Effective interventions featured longitudinal pharmacist follow-up, comprehensive patient assessment, monitoring, medication management, and collaborative practice agreements.
- Pharmacist-led interventions demonstrated positive impacts on patient management and satisfaction.
Conclusions:
- Pharmacists play an integral role in improving outcomes for patients with CKM conditions within interprofessional settings.
- Further research is required to robustly investigate the specific cardiovascular, kidney, and metabolic outcomes associated with pharmacist interventions.
Background:
Co-existence of multiple cardiovascular-kidney-metabolic (CKM) conditions, such as chronic kidney disease (CKD), type 2 diabetes (T2D), and cardiovascular disease, is common. The interconnected nature of CKM conditions emphasizes the need for an interprofessional approach to patient care. As the prevalence of people with CKM conditions continues to rise in the United States and the burden on the health care system increases, clinical pharmacists are well-positioned to provide support within interprofessional teams and improve patient access to care through delivery of education, assessments and monitoring, and optimal initiation and maintenance of guideline-directed medical therapy (GDMT).
Methods:
This scoping review explored interprofessional team-based interventions that incorporated pharmacists into the management of CKM conditions in the U.S. Searches were conducted in Embase and MEDLINE for relevant studies published in English between January 1, 2015 and February 14, 2025, in a patient population with > 5% of patients with both CKD and one or more cardiovascular or metabolic conditions. Outcomes investigated included estimated glomerular filtration rate, urine albumin-to-creatinine ratio, glycated hemoglobin, and systolic and diastolic blood pressure, as well as patient and physician satisfaction with pharmacist interventions.
Results:
A total of 28 studies met the eligibility criteria, including 18 randomized clinical trials, 4 pilot studies, and 6 observational studies. Effective interventions generally included longitudinal follow-up with multiple pharmacist visits over time, comprehensive pharmacist involvement including patient assessment, monitoring, and medication management, and direct deployment of pharmacist-led interventions through collaborative practice agreements.
Conclusions:
This scoping review demonstrates an integral and direct role for pharmacists in improving outcomes for patients with CKM conditions in interprofessional settings. However, there is a need for more robust studies that investigate cardiovascular, kidney, and metabolic outcomes in these patients.
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