Evaluation of knowledge and attitude concerning augmented renal clearance among physicians and clinical pharmacists in Al-Ain, UAE: A cross-sectional study

TL;DR

This study assesses healthcare providers' knowledge of augmented renal clearance in UAE hospitals, finding a lack of awareness and a need for better training and guidelines.

Contribution

The study provides new insights into the knowledge gaps of physicians and pharmacists regarding augmented renal clearance in the UAE healthcare setting.

Findings

Only 61.9% of participants were aware of augmented renal clearance (ARC), and 78% demonstrated poor knowledge overall.

Clinical pharmacists showed better knowledge than physicians, but most were unaware of the eGFR threshold for ARC.

85% of participants expressed a positive attitude toward seeking more information on antibiotic dose adjustments for ARC patients.

Abstract

Kidney function assessment is crucial in critical illness patients and is required before administering renally excreted medication, especially antibiotics and antiepileptics. Conventional clinical practice often focuses on renal impairment with low creatinine clearance (CrCl) and overlooks the augmented renal clearance (ARC), which is defined by (CrCl) more than 130 ml/min. This typical demonstration neglects individuals who experience hyperfunctioning kidneys. Among critically ill patients, the prevalence of (ARC) is approximately 20% to 65% of cases. This study aims to evaluate physicians’ and clinical pharmacists’ knowledge about ARC-associated risk factors, antibiotic regimen modification in ARC patients, and attitudes towards ARC workshops and guidelines in Al-Ain, UAE.

A cross-sectional, online self-administered survey-based study was designed to achieve this study’s aim. The questionnaire was constructed on profound literature analysis, validated, and piloted. The survey was emailed to physicians and pharmacists working in two hospitals, private and governmental, and distributed through different social media platforms over three months, December 2022—February 2023.

Of the 92 complete responses (32 clinical pharmacists, 60 physicians), 57 (61.9%), were aware of ARC, but 72 (78%) demonstrated poor knowledge overall. Clinical pharmacists had a higher mean rank of knowledge than the physician’s group. Meanwhile, 70 (76.1%) participants were unaware of the eGFR threshold to determine ARC. There is a noticeable positive attitude toward seeking more information about antibiotic dose adjustment in ARC patients at 85 (92%) of the respondents. Remarkably, only 28 (30.4%) were directly involved with ARC patients’ treatment plans.

In conclusion, clinical pharmacists showed better knowledge than physicians. However, overall, the participating healthcare providers lacked knowledge about ARC, so a reliable source of information regarding ARC should be utilized. Future research could explore the implementation of professional development workshops for healthcare providers and national guidelines and then assess their impact on patient outcomes.

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