GPs and pharmacists discuss implementing acute kidney injury sick day guidance

The work described here was presented at the Pharmacy Together 2019 conference.

Acute Kidney Injury (AKI) is rising and is now one of the top ten conditions causing admission to hospital. Sick day guidance relates to advising patients to temporarily stop certain medicines when they are not feeling well. 

Community pharmacists are well placed to provide effective measures such as a brief intervention, and could help to prevent, delay and manage kidney injury in the community. We aimed to explore the attitudes and perceptions of General Practitioners (GPs) and community pharmacists on the management of AKI in the community and to describe the barriers and facilitators to optimal management of AKI.

Qualitative in-depth semi-structured interviews were conducted with four community pharmacists and six general practitioners. Interview data was coded and analysed using constant comparison of the data via a thematic analysis process. Purposive sampling was undertaken to obtain a diverse as possible group of healthcare professionals within each profession.

Overall, the concept of AKI sick day guidance was well received by the participants. They saw the benefit of their use in primary care and were keen to see them being used in practice. However, moving from the concept of AKI sick day guidance to implementation in practice was much more difficult to come to a unified conclusion of what best practice should look like. 

Factors affecting implementation included: 

  1. professional credibility and responsibility to deliver the service
  2. uncertainty and strength of relations to deliver a unified approach, and
  3. the resources, including time, to change current practice.

To be able to take AKI sick day guidance forward a clear partnership and buy-in from both community pharmacists and GPs is required, with a closer working relationship and understanding of each other’s knowledge and skills. A clear pathway is required for all healthcare professionals to be comfortable in their role relating to AKI management and that these roles are agreed and clearly defined. 

This work was presented as a poster at the Pharmacy Together 2019 conference, organised by UKCPA and Pharmacy Management.

Additional authors:

Professor Scott Wilkes, University of Sunderland, and Dr Sue Shaw, Royal Derby Hospital.

The opinions expressed in this article are those of the author. They do not purport to reflect the opinions or views of the UKCPA or its members. We encourage readers to follow links and references to primary research papers and guidance.

Competing interest statement: 

The author declares: support from the Health Education Foundation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.


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