Demonstrating the value of community pharmacists in New Zealand educating a targeted group of people to temporarily discontinue medicines when they are unwell to reduce the risk of acute kidney injury

Abstract

Abstract Objective Acute kidney injury (AKI) prevention strategies for community-acquired AKI associated with severe acute illness have received attention in recent years. The objective of this study was to evaluate a community pharmacist AKI education programme aimed at patient self-management during acute dehydrating illnesses. Methods This was a multimethod study. Potential participants were identified by community pharmacists when they presented a prescription containing a study medicine. The intervention consisted of completion of a short demographic questionnaire and a pharmacist providing verbal AKI information and advice on self-management during acute dehydrating illness, including medicine withholding. This information was supported with take-home information. Participants were telephoned between 4 and 11 months later and invited to participate in a structured telephone interview. Descriptive statistics were generated from questionnaire responses, and interview data were analysed using manifest content analysis. Key findings One hundred and thirteen adults were recruited and 93 (82%) interviewed. Fifty-four (58%) interviewees remembered the pharmacist’s education, and 51 (55%) had retained the information sheet. Fifty-eight (62%) would temporarily withhold medicines during acute dehydrating illnesses. Thirty-nine were comfortable they knew when to restart their medicines; 15 (38%) indicated this was once symptom-free for 48 h. Forty-six interviewees were comfortable about contacting their general practice; 16 (35%) would do this after 24 h of illness. Participants found the educational content and pharmacist approach acceptable. Conclusion A majority of participants accepted and remembered the information provided by their community pharmacist and felt comfortable to self-manage during acute dehydrating illness. A caveat is participant actions in practice may not be consistent with stated intentions.