Pharmacists' participation in the management of chronic kidney disease: a systematic review / 中国药学杂志

ABSTRACT

OBJECTIVE: To evaluate the effect of pharmacists' interventions in the management of chronic kidney disease. METHODS: CENTRAL, MEDLINE OVID SP, EMBASE OVID SP, CNKI and Wanfang Data were searched for studies regarding pharmacists' interventions in CKD patients. Methodological quality of RCTs included was assessed using the Cochrane Collaboration's tool for assessing risk of bias. RESULTS: Twenty - seven studies were included. Among them there were 13 RCTs, 8 quasi-randomized controlled trials, 5 cohort studies and 1 economic study. Only 1 of the included RCTs presented a low risk of bias, while the rest were all with unknown risk. The results showed that pharmacists' interventions significantly reduced the rates of ESRD and all-cause death, decreased the number of transplant rejections and adverse reactions, while improving the standard rate of drug concentrations. Pharmacists' interventions made patients' serum creatinine, blood pressure, lipids, glucose and phosphate level under control, at the same time they played a positive role in the management of secondary hyperparathyroidism and anemia. In addition, pharmacists' interventions significantly improved patients' quality of life, as well as their medication compliance and knowledge. They also saved much money for institutions and patients. CONCLUSION: Pharmacists' participation seems to have a positive impact on the control of diseases, the enhancement of life quality, the improvement of medication compliance and knowledge, and the alleviation of financial burden. However, high-quality clinical evidence is still needed to assess the degree of this impact.