February 4, 2015
Community Pharmacists Provide Education on
NSAID-Related Kidney Risks

Albany, NY—A brief educational intervention by community pharmacists in upstate New York helped patients at risk for acute kidney injury (AKI) better understand the effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on the condition.

A study recently published in the national Centers for Disease Control and Prevention’s publication, Preventing Chronic Disease, shows how information provided at community pharmacies improved patient knowledge on NSAID-associated risks.

“Pharmacists practicing in the community can partner with primary care providers in the medical home model to educate patients at risk for AKI,” write the authors of the study, which was led by researchers from the Albany, NY, College of Pharmacy and Health Sciences.

Background information in the article discusses how NSAIDs are frequently associated with community-acquired AKI, a strong risk factor for development and progression of chronic kidney disease.

“Frequent, unmonitored use of NSAIDs among high-risk patients is associated with the development of acute and chronic kidney injury. NSAID use is a common inciting factor for community-acquired acute kidney injury (AKI). NSAID-induced AKI abruptly alters renal hemodynamics, lowering effective perfusion of the glomerulus,” according to the report, which adds, “Interruption of this regulatory pathway increases the risk for hemodynamically mediated AKI, especially in patients who depend on vasodilatory prostaglandins to maintain kidney perfusion.”

In fact, the authors note, “Concomitant use of antihypertensive drugs and NSAIDs has been associated with a 5-fold increase in AKI risk. The relative risk for AKI among concurrent users of NSAIDs and diuretics is 3-fold higher than the risk among non-concurrent users, likely because of decreased intravascular volume and renal perfusion.”

For the study, patients receiving prescription medications for hypertension or diabetes mellitus were invited to participate in an educational program on the risks of NSAID use. Before and after the intervention, patients completed a questionnaire consisting of five questions scored from 1 to 5. In addition, information was collected on age, race, sex, and frequency of NSAID use.

The NSAID avoidance education program was delivered by 24 pharmacy interns in the last year of the doctor of pharmacy program at Albany College of Pharmacy and Health Sciences. The program was a requirement for interns who were completing a 6-week experiential rotation in a Community Pharmacy Advanced Pharmacy Practice Experience site during three consecutive six-week rotations from January through April 2011.

The questionnaires were completed by 152 participants—60% female with an average age of 54.6. Mean preintervention knowledge score as measured by the questionnaire was 3.3, and postintervention score was 4.6.

On a scale of 1-5, with 5 denoting “extremely useful,” the participants rated the program. 4.2. With 48% of the patients saying they currently took NSAIDs, 67% reported that the program encouraged them to limit use of the medications.

“Provision of NSAID avoidance education to patients at risk for AKI is an important but underappreciated prevention strategy,” the authors write. “Community pharmacists are readily accessible to these high-risk patients as they visit the pharmacy for prescription refills and over-the-counter purchases.”


U.S. Pharmacist Social Connect