Avoiding acute kidney injury in primary care: attitudes and behaviours of general practitioners and community pharmacists in Hawke’s Bay
Dianne Vicary 1 4 , Colin Hutchison 2 , Trudi Aspden 3
+ Author Affiliations
- Author Affiliations
1 Vicary Pharmacy Services Limited, Napier, New Zealand
2 Hawke’s Bay District Health Board, Hastings, New Zealand
3 School of Pharmacy, University of Auckland, Auckland, New Zealand
4 Corresponding author. Email: dianne.vicary@xtra.co.nz
Journal of Primary Health Care 12(3) 244-256 https://doi.org/10.1071/HC19106
Published: 22 September 2020
Journal Compilation © Royal New Zealand College of General Practitioners 2020 This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License
Abstract
INTRODUCTION: Awareness of the effect of acute kidney injury on patient outcomes and health systems is growing internationally. New Zealand’s approach focuses on stopping consumption of ‘at-risk’ medicines when acute kidney injury has been established and raising awareness of the risks associated with the Triple Whammy drug combination.
AIM: To explore current practices and views of Hawke’s Bay general practitioners (GPs) and community pharmacists regarding patient education about medicines with potential for contributing to community-acquired acute kidney injury, with a focus on community pharmacists providing patient education regarding when to temporarily withhold ‘at-risk’ medicines during acute dehydrating illnesses.
METHODS: Two tailored cross-sectional online anonymous surveys of GPs and community pharmacists working in Hawke’s Bay were administered between 2015 and 2016. Descriptive statistics were generated from the closed-question responses and manifest content analysis was applied to the free-text responses.
RESULTS: Twenty-two percent (37/167) of GPs and 34% (32/95) of pharmacists responded. Most respondents, GPs (34/37) and pharmacists (25/32), self-reported expertise to educate patients on temporarily withholding ‘at-risk’ medicines during acute dehydrating illnesses. Twenty-nine (78%) GPs had confidence in pharmacists providing this patient education and 20 (54%) welcomed pharmacist contact regarding a Triple Whammy prescription. However, for a variety of reasons, pharmacists did not routinely provide this education or contact GPs.
DISCUSSION: Both GPs and community pharmacists reported they had expertise to provide useful patient education about ‘at-risk’ medicine use during acute dehydrating illnesses. Dialogue to clarify the role of the two groups would be beneficial to achieve a more coordinated approach to patient care. Relevant strategies and frameworks already exist, but national interprofessional leadership and local application would be beneficial.
Keywords: General Practitioners; pharmacy services; primary health care; counselling practice
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