Chronic kidney disease and adherence improvement program by clinical pharmacist-provided medication therapy management; a quasi-experimental assessment of patients' self-care perception and practice

Rationale: One of the critical roles of pharmacists in the field of community and hospitals is to provide medication therapy management (MTM) services and reconciliation.

Objectives: This study aimed to assess the perceptions, adherence, and performance of the patients with chronic kidney disease (CKD) to the clinical pharmacist-provided MTM before and after receiving this service.

Method: A cross-sectional survey was conducted from June 2023 to January 2024. A validated questionnaire assessed patients' knowledge, attitude, and performance, and the Morisky medication adherence scale evaluated the medical adherence of the patients before and after the clinical pharmacist-provided MTM. Inclusion criteria were patients with CKD according to NKF KDOQI guidelines and GFR < 60 mL/min/1.73 m². Before and after the MTM service, CKD patients' knowledge, attitude, performance, and adherence to their pharmacotherapy were assessed.

Results: A total of 100 patients enrolled in the study and completed the questionnaire. Before and after the MTM service, total knowledge was 3.38 ± 1.82 and 7.59 ± 1.11, respectively. Before and after the MTM service, the attitude score was 54.53 ± 5.05 and 59.24 ± 4.68, respectively. Before and after the MTM service, the mean performance score was 30.15 ± 4.27 and 34.54 ± 2.56, respectively. Adherence score to medications before and after the MTM service was 4.86 ± 1.99 and 6.22 ± 1.39, respectively. In all fields, outcomes significantly improved (P < 0.05).

Conclusion: The current study showed the critical role of clinical pharmacists in training patients about medications and improving adherence to their pharmacotherapy.