(ID: 156) Evaluating a pharmacist-led cardio-renal-metabolic service to reduce healthcare inequities in a socioeconomically deprived population

Abstract Introduction Chronic kidney disease (CKD) is a leading cause of premature mortality [1]. It commonly occurs with cardiovascular disease and diabetes mellitus and disproportionately affects socioeconomically deprived groups [2–4]. CKD is projected to increase due to an ageing population and the growing prevalence of obesity and diabetes [1]. General practice clinical pharmacists (GPCPs) have been shown to be effective at addressing a range of challenging areas of prescribing and chronic disease management, however the role of GPCPs services for CKD has not been explored [5]. Aim To scope the potential of a GPCP-led multidisciplinary intervention optimising the management of patients with stage 3–4 CKD. Methodology Prospective intervention scoping study in two urban general practices serving highly socioeconomically deprived communities, November 2021 to January 2024 within NHS Greater Glasgow and Clyde, Scotland, UK. Patients with CKD stages 3a to 4 were identified from practice records and GP referrals. All were invited to attend the GPCP-led review clinic. The GPCP-led intervention involved: patient education; life-style advice; CKD monitoring; medicines initiation, optimisation and deprescribing. Anonymised pre- and post-intervention data was analysed. The West of Scotland Research Ethics Service Scientific Officer advised the project is a service evaluation, not requiring ethical approval. Results In total, 253 patients, median age 77 (range 26 to 99) years-old met inclusion criteria; 62% female. Of those, 163 (64%) attended for review. From baseline to 12 months post-intervention, sustained improvements in patients’ CKD stages, and reductions in patients’ blood pressures, lipid profiles, and glycated haemoglobin were observed to varying degrees. Discussion This study is the first of its kind to describe a novel approach to utilising GPCPs to support cardio-renal and metabolic management within general practice. Furthermore, it was trialled in a socioeconomically deprived, making it relevant for real-world challenges. This study is limited by that absence of usual care comparator and sample size which limits generalisability. However, the multidisciplinary and service-design approach may help inform future research and workforce solutions in primary care. An integrated GPCP-led multidisciplinary general practice-based CKD review clinic demonstrated potential to optimise management, however further robust studies are needed.