Survey of care provided by ambulatory care pharmacists to patients with chronic kidney disease

Purpose. A survey was conducted to determine the role of ambulatory care pharmacists in the care of patients with chronic kidney disease (CKD). Methods. Data from a survey of ambulatory care pharmacists in the treatment and management of patients with CKD were collected. A 22-item anonymous survey was sent to 1028 potential respondents in January 2004. Only pharmacists indicating routine provision of care to patients with risk factors for the development of CKD or with stages 1-4 of CKD were included in the analysis. Additional questions surveyed the timeliness and frequency of nephrology referrals and the pharmacists' familiarity with National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI) guidelines. Results. Of 1028 surveys, 535 were completed and returned. Only respondents who provided care in an outpatient setting to geriatric patients and patients with diabetes mellitus, hypertension, or decreased creatinine clearance were included in the analysis (n = 388). Initial assessment of CKD was performed by 85% of the surveyed pharmacists. Over one third of the pharmacists made nephrology referrals. However, even pharmacists who had a high percentage of patients with a known risk for CKD infrequently screened for kidney dysfunction, and only a small portion monitored the areas recommended by NFK-K/DOQI. The respondents' familiarity with the NFK-K/DOQI guidelines indicated that 7% were very familiar, 45% were somewhat familiar, 34% were not very familiar, 13% were not at all familiar, and 1% did not respond. Conclusion. The ambulatory care pharmacists surveyed were not consistently involved in the routine monitoring of common complications of CKD.