OUTCOME OF MEDICATION THERAPY MANAGEMENT IN GERIATRIC CHRONIC KIDNEY DISEASE PATIENTS AT CHRONIC KIDNEY DISEASE CLINIC OF A COMMUNITY HOSPITAL IN KALASIN PROVINCE

Abstract

The study aims to monitor the outcome of medication therapy management (MTM) in elderly with chronic kidney disease (CKD) patients at CKD clinic. A prospective quasi experimental study was performed in patients aged > 60 years with diabetes and CKD stage 3 or higher. Clinical outcomes were monitored for three times, at baseline (before MTM provision by pharmacist) and at follow up visit. Data collection by using data collection form and analyzed by using descriptive statistic. The differences were analyzed paired t-test, ANOVA and Wilcoxon signed rank test.

Result: At the end of study, there were 73 patients. Most of them were females (75.3%) and most aged 60-70 years (64.4%). Most patient had CKD stage 3a, (41.1%). There were 43 drug related problems (DRP) and the acceptance rate of the physicians to pharmacist's intervention was 97.7%. There were 17 patients who were follow up at 0, 1, 3 months and 56 patients who were follow up at 0, 2, 4 months. On average, the clinical parameters that the value decreased from baseline was fasting blood sugar but the clinical parameters that the value increased from baseline were serum creatinine and hemoglobin A1C but the difference did not reach statistical significance.

Conclusion: MTM provision by pharmacist can detect and correct DRPs in elderly patients with chronic kidney diseases and diabetes. Most of pharmacist interventions were accepted by the physicians. Therefore, this MTM should be continued.