Exploring The Effects Of Pharmacist-Led Intervention On Perceptions And Practices Of Pharmacological Thromboprophylaxis Prescribing In Patients With Renal Impairment

Abstract

Background: Chronic kidney disease (CKD) is linked to numerous consequences, with venous thromboembolism (VTE) being one of the most significant. The prevalence of venous thromboembolism (VTE) is elevated in cases of severe kidney disease; however, the association between less severe chronic kidney disease (CKD) and VTE risk remains ambiguous. Considering the rising global incidence of chronic kidney disease (CKD), it is essential to mitigate the related risk of devastating vascular consequences, such as stroke. Therapeutic alternatives for mitigating the risk of all stroke subtypes in individuals with chronic kidney disease are still constrained. The quantity of anticoagulants approved for the prevention and treatment of thromboembolic disorders has risen. Irrespective of the anticoagulants used, prior studies indicate that improper utilization in patients with renal impairment elevates the risk of bleeding.

Objective: improve the knowledge and practice of pharmacological thromboprophylaxis prescribing in patients with renal impairment.

Methodology: An interventional study was undertaken to improve the knowledge of nephrologist regarding anticoagulants use among patients with renal impairment at healthcare institutions in Najaf Province. The intervention includes lectures, brochures, roll-ups, and checklists regarding the recent recommendations of guideline for appropriate anticoagulant use in individuals with renal impairment. The study had two groups of physicians based on whether they received the intervention or not named intervention and control groups respectively. The knowledge of both groups was examined by questioner at three periods but only interventional group has received the intervention. The suitability of the intervention was evaluated at three intervals: baseline, four weeks post-intervention, and twelve weeks post-intervention, to assess the knowledge for utilizing the CHAD-VASC scoring system for stroke risk and the PADUA scoring system for VTE risk.

Results: the result revealed that baseline data highlighted a significant gap in the knowledge of nephrologists regarding anticoagulant use in patients with renal impairment. However, the knowledge of nephrologists significantly increased when compared to control group at three interval includes baseline, 4 weeks and 12 weeks post-intervention.

Conclusions: intervention can significantly increase the knowledge among participant nephrologists. With notable and long-lasting increases seen at 4 and 12 weeks, the educational intervention clearly raised participant's knowledge. These findings emphasize the need of organized education in improving such knowledge over time.