{
  "abstract": "Background and Importance Chronic Kidney Disease (CKD) is defined as abnormalities of kidney structure or function, present for a minimum of 3 months and has a global prevalence of approximately 10%. Patients with CKD are at an increased risk of drug-related problems (DRPs) due to polypharmacy, comorbidity burden, reduced renal drug clearance, and frequent use of high risk or nephrotoxic medicines. Pharmacists’ interventions (PIs) support the safe and effective use of medicines in CKD patients and form an integral part of the renal multidisciplinary team.Aim and Objectives The aim of this study was to evaluate DRPs and pharmacists’ interventions in renal inpatients, and to assess the perceived severity of DRPs identified.Material and Methods A 2-week prospective observational study was conducted on the nephrology ward in a university teaching hospital. Inpatients with renal disease, admitted under a nephrologist were included. Renal pharmacists recorded DRPs identified and resultant interventions made using Microsoft Forms. DRPs were categorised by type and source of intervention, renal disease and drug class. Collected data were extracted to Microsoft Excel and analysed using descriptive statistics. The severity of DRPs was assessed using the Dean and Barber method. The Intraclass correlation coefficient (ICC) was calculated using SPSS version 29.0.1.0, to assess inter-rater reliability.Results 80% (n=42) of eligible patients had DRPs recorded, with a mean of 3.2 (SD ±2.97) per patient. Mean DRP was highest among kidney transplant recipients and haemodialysis patients (5 (SD±3.65) and 4.8 (SD ±2.59) respectively). ‘Commence medication’ was the most frequent PI recorded (27%, n=44). 92% (n=154) of DRPs were identified by reviewing patients’ medicines and prescription record (MPAR) or medicines reconciliation. Cardiovascular drugs were most frequent drug class involved in DRPs (26%, n=43). 99% (n=163) of DRPs were classified as moderate or severe. 92% (n=152) of DRPs were resolved following PIs.Conclusion and Relevance This study highlights the pivotal role of renal pharmacists in the identification and resolution of DRPS in renal inpatients, with the majority of DRPs classified as moderate or severe and successfully resolved following pharmacist intervention. Future work should consider the economic benefits of the renal/specialist renal clinical pharmacy service and cost of administration errors.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Cork University Hospital, Pharmacy Department, Cork, Ireland Rep"
      ],
      "name": "J O’donnell"
    },
    {
      "affiliations": [
        "Cork University Hospital, Pharmacy Department, Cork, Ireland Rep"
      ],
      "name": "A Keating"
    },
    {
      "affiliations": [
        "Cork University Hospital, Pharmacy Department, Cork, Ireland Rep"
      ],
      "name": "V Silvari"
    },
    {
      "affiliations": [
        "Cork University Hospital, Pharmacy Department, Cork, Ireland Rep"
      ],
      "name": "M Flynn"
    },
    {
      "affiliations": [
        "Cork University Hospital, Nephrology, Cork, Ireland Rep"
      ],
      "name": "T O’sullivan"
    },
    {
      "affiliations": [
        "Cork University Hospital, Pharmacy Department, Cork, Ireland Rep"
      ],
      "name": "D Lynch"
    },
    {
      "affiliations": [
        "Cork University Hospital, Nephrology, Cork, Ireland Rep"
      ],
      "name": "M Burke"
    }
  ],
  "title": "4CPS-055 An exploration of renal pharmacist interventions in renal inpatients on the nephrology ward in a university teaching hospital",
  "uid": "b6c7ec62-9830-576f-9652-6fec49a241db"
}