Clinical Pharmacist-Led Cardiovascular Risk Assessment in Patients With Chronic Kidney Disease (CRICKD) - NCT07927959

Chronic kidney disease (CKD) is a long-term condition that can increase the risk of cardiovascular diseases, such as heart attacks and strokes. People with CKD often have other health conditions and take several medications, which can make following treatment plans challenging. Clinical pharmacists may help these patients by reviewing their medications, providing education, and supporting medication adherence and cardiovascular risk management. This study evaluated the impact of a clinical pharmacist-led pharmaceutical care program on cardiovascular risk, medication adherence, and quality of life in hospitalized adults with CKD. The study was conducted at a research and training hospital in Istanbul, Türkiye, with a planned six-month follow-up. A total of 150 patients were initially enrolled and assigned to either an intervention group or a control group. Due to deaths, withdrawal from the study, and loss to follow-up, 101 patients were included in the final analysis. Patients in the control group received standard medical care. Patients in the intervention group received additional pharmaceutical care from a clinical pharmacist, including medication review, education about CKD and cardiovascular risk factors, counseling on medication adherence and lifestyle changes, and follow-up counseling. The study assessed cardiovascular risk using a Framingham-based risk model. Medication adherence and health-related quality of life were evaluated using standardized questionnaires. Medication regimen complexity and relevant clinical measurements were also assessed. The findings showed that cardiovascular risk scores decreased in both groups during the study period. Medication adherence increased in both groups, from 59.2% to 75.5% in the control group and from 75.0% to 88.5% in the intervention group. However, the difference in medication adherence between the groups at follow-up was not statistically significant. Quality-of-life scores were significantly higher in the intervention group at both baseline and follow-up. A weak negative correlation was observed between medication regimen complexity and quality of life, indicating that greater medication complexity was associated with lower quality-of-life scores. Overall, the findings suggest that clinical pharmacist-led pharmaceutical care may support medication management in patients with CKD. However, the study did not demonstrate statistically significant differences between groups in medication adherence or cardiovascular risk outcomes. Further studies with larger samples and adequate follow-up are needed to clarify the effects of pharmacist-led interventions in this population.