Assess the Impact of the Pharmacist on Enhancing Pharmacological Thrombo-Prophylactic Prescriptions in Patients with Renal Impairment

Abstract

ABSTRACT

Patients with chronic kidney disease (CKD), irrespective of the extent of renal impairment, are acknowledged to have an elevated risk for venous thromboembolism (VTE) and stroke; yet, study findings on the association between CKD and the heightened risk of VTE and stroke have been inconclusive. Venous thromboembolism (VTE) predominantly arises during hospitalization for significant surgical procedures or trauma, however it may potentially manifest several months post-surgery. The quantity of anticoagulants approved for the prevention and treatment of thromboembolic disorders has risen. Irrespective of the anticoagulants employed, prior studies indicated that improper utilization in patients with renal impairment elevates the risk of hemorrhage. An interventional study was done to evaluate the proper utilization of anticoagulants in patients with renal impairment within healthcare institutions in Najaf Province. Intervention consists of lectures, brochures, rollups and buck lists about updated guideline of safe anticoagulant use in patients with renal impairment. The study included two patients' groups according to receiving intervention or not. the appropriateness of intervention was assessed at 3 periods preintervention, 4 weeks after-intervention and 12 weeks after intervention according to CHAD-VASC scoring system for stroke risk and PADUA scoring system for VTE risk. Results shown that at baseline there were no significance difference between two groups according to Chi-square analysis with respect to inappropriate prescribing of anticoagulants. after 4 weeks of intervention the is significant decline in percentage of patients receiving inappropriate anticoagulants (9%) in comparison to patients not received intervention (23.5%). After 12 weeks of intervention the is significant decline in percentage of patients receiving inappropriate anticoagulants (2.5%) in comparison to patients not received intervention (21.5%). The results also shown that inappropriate prescribing has been improved dramatically after 12 weeks in comparison to 4 weeks of intervention. This study demonstrated that appropriate prescribing of anticoagulants in CKD patients significantly improved following the intervention and Prolonged monitoring is advised to evaluate the enduring effects of this intervention.