New Study Puts Community Pharmacists at Forefront of Diabetic Kidney Disease Therapy

Clinical algorithms may present new opportunities for community pharmacists in diabetic kidney disease care. The results of a new study create a mechanism for pharmacists to assist with initiating and optimizing the treatment of the disease.¹

Clinical decision support systems based on algorithms have improved outcomes and reduced costs in other health care settings. In one study, a Texas hospital saw a 105% increase in its clinical interventions and more than $1 million in annual cost savings due to such a system.¹

Clinical algorithms outlined treatment for diabetic kidney disease | Image credit: © UniqGraphicX | stock.adobe.com

In a new study, researchers aimed to put community pharmacists at the forefront of treating diabetic kidney disease using clinical algorithms. Findings were published in the Canadian Journal of Kidney Health and Disease.²

Investigators asked pharmacists to evaluate clinical algorithms outlining the recommended treatment of diabetic kidney disease. Included in the algorithms were guidelines for pharmacist interventions in the following areas²:

• Detection of type 2 diabetes and diabetic kidney disease
• Use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers
• Initiation and management of sodium-glucose co-transporter-2 receptor blockers
• Administration of finerenone (Kerendia; Bayer), a nonsteroidal mineralocorticoid receptor antagonist

The population included patients with an estimated glomerular filtration rate of 30 to 60 ml/min/1.73m². The algorithms went through content verification to determine that they were comprehensive, accurate, and appropriate, as well as face verification to ensure they were clear and usable by the end users.²

The item-level content validity index of each item of the algorithms per round ranged from 0.83 to 1, meeting the content validity threshold of 0.83 (P <.05) for at least 6 participants. The overall scale-level content validity index across 3 rounds was 0.97. The overall percentage of participants across 3 rounds who agreed or strongly agreed to 5 face validity statements ranged from 83% to 100%, which was above the prespecified threshold for face validity consensus.²

The authors noted that diabetes is a leading cause of kidney disease, accounting for 38% of cases of kidney failure requiring dialysis. They added that community pharmacists are well-positioned to help these patients, especially those without access to a nephrologist.²

This was the first study to develop and validate algorithms for a new model of care utilizing community pharmacists to identify and manage type 2 diabetes and chronic kidney disease in primary care. Future studies are planned to determine the efficacy and safety of the algorithms.²

REFERENCE

1. Calloway S, Akilo HA, Bierman K. Impact of a clinical decision support system on pharmacy clinical interventions, documentation efforts, and costs. Hosp Pharm. 2013;48(9):744-752. doi:10.1310/hpj4809-744

2. Morris J, Battistella M, Tennankore K, et al. Optimizing prescribing for individuals with type 2 diabetes and chronic kidney disease through the development and validation of algorithms for community pharmacists. Can J Kidney Health Dis. 2025;12:20543581241309974. doi:10.1177/20543581241309974