Primary care teams, managing acute kidney injury and the role of medicine management pharmacists
Mr B is a 72 year old man with type 2 Diabetes, COPD & stage 3 CKD. On multiple medicines including repeat prescriptions for an ACE Inhibitor and Ibuprofen (NSAID).
Mr B experienced an episode of gastroenteritis – without a GP assessment this led to an unplanned hospital admission. The episode of illness was complicated by acute kidney injury requiring a period of intensive care.
The hospital discharge summary included acute kidney injury – but was not then coded in GP records. Recommendation was that the ACE Inhibitor was to be suspended, but there was no mention of NSAIDS. Neither drugs were suspended by the primary care team. Kidney function was not rechecked post-discharge.
Further GP appointments and treated for exacerbations of COPD. No temporary cessation of medicines during these episodes of acute illness.
Who would the learning opportunities be relevant to?
- General Practice teams including role of medicine management pharmacists
Key Learning Opportunities
- Case discussion at a weekly clinical meeting with medicines management pharmacist led to the development of register for patients who have experienced an episode of acute, along with e-alerts to ensure patients have medication review and renal function rechecked post discharge.
From which Clinical Perspective?
- General Practitioner