# Multicenter Renal Pharmacist Group—Pharmaceutical Care for Patients with Renal Impairment at Four Non-University Hospitals in Germany

## TL;DR

This study shows that adding renal pharmacists to hospital teams in Germany improved medication safety for patients with kidney problems.

## Contribution

The study demonstrates the successful implementation of renal pharmacist services in non-university hospitals to enhance pharmaceutical care for patients with renal impairment.

## Key findings

- 3924 patients were visited, with 1425 (36.3%) receiving interventions for renal-drug-related problems.
- 77.6 to 88.2% of identified renal-drug-related problems were resolved in collaboration with physicians.
- Common issues included 'dosage too high' and 'contraindication' in medication prescriptions.

## Abstract

Background: The project ‘Multicenter Renal Pharmacist Group—Implementation of Pharmaceutical Care for Patients with Renal Impairment at four Non-University Hospitals in Germany’ started in the beginning of 2020 with the goal to establish high-quality pharmaceutical care to improve patient safety for hospitalized patients with renal impairment at German non-university hospitals. Pharmaceutical service quality should be optimized by intense and effective intraprofessional collaboration within the network. Methods: Over a period of two years (2020–2022), we implemented renal pharmacists (RPs) for patients with renal impairment (RI) at four non-university hospitals in Germany (Starnberg Hospital, Rudolf Virchow Hospital Glauchau, Catholic Hospital in the Märkisch District (KKiMK), and Hospital Sindelfingen-Boeblingen). The RPs conducted medication analyses identifying renal-drug-related problems (rDRPs) two to five days a week. The rDRPs, including recommendations to solve them, were forwarded to the attending physicians via written consultations or personally during ward rounds. The RPs were mentored by a renal pharmacist expert from LMU Munich and formed a multicentered team with close collaboration. Data about the RP service were collected and were retrospectively evaluated. Results: During the two-year project period, a total of 3924 patients from various disciplines were visited across all four locations. In total, 1425 patients (36.3%; with a range from 22.7 to 56.4% between hospitals) received one or more interventions by RPs concerning 2454 rDRPs (a median of one to three rDRPs per patient). In cooperation with the physicians, 77.6 to 88.2% of the rDRPs were solved. The most common causes were ‘dosage too high’ and ‘contraindication’. Conclusion: The implementation of pharmaceutical care for patients with renal impairment at four non-university hospitals in Germany increased appropriate prescribing by physicians. The multicenter team proved to be an excellent support for the newly established services.