RESULTS OF THE DEVELOPMENT OF A PHARMACEUTICAL CARE SYSTEM FOR PATIENTS WITH CHRONIC KIDNEY DISEASE IN PRIMARY CARE UNITS, MUEANG PHATTHALUNG DISTRICT

Abstract

This quasi-experimental study evaluated the effectiveness of a developed pharmaceutical care system for patients with chronic kidney disease (CKD) in primary care settings in Mueang Phatthalung District, Phatthalung Province, Thailand. The intervention included the development of a medication surveillance system integrated into the JHCIS database, systematic CKD patient screening, identification of drug-related problems (DRPs), and implementation of renal dose adjustment guidelines in primary care units. A total of 180 patients with CKD stages 3–5 who received services at primary care units between November 11, 2024, and November 11, 2025, were included. Data were collected using pharmaceutical care documentation forms, the Thai Medication Adherence Scale, and renal dosing guidelines. Descriptive statistics were used to summarize patient characteristics and outcomes, and a paired samples t-test was applied to compare pre- and post-intervention results. Following implementation of the pharmaceutical care system, the number of DRP events decreased from 77 to 12. The proportion of patients with good medication adherence increased from 86.67% to 96.11%. In addition, the estimated glomerular filtration rate (eGFR) significantly improved from 49.01 ± 7.71 ml/min/1.73 m² to 50.99 ± 8.64 ml/min/1.73 m² (p < 0.001). These findings demonstrate that a pharmacist-led pharmaceutical care system in primary care can effectively reduce drug-related problems, improve medication adherence, and contribute to slowing renal function decline in patients with chronic kidney disease. The integration of clinical pharmacy services into primary care may enhance medication safety and clinical outcomes in CKD management.