CENTRE FOR PHARMACY POSTGRADUATE EDUCATION OPT106 October 2017 Introduction The National Institute for Health and Care Excellence (NICE) estimates that acute kidney injury (AKI) is the cause of 13 to 18 percent of people admitted to hospital. 1 As a pharmacy professional you can help patients and the public understand the importance of kidney health. This Optimise programme will give you a greater understanding of the biochemical changes that occur during AKI and will encourage you to reflect on how to explain these to patients.You will gain confidence to discuss the meaning of patients’ test results with them and offer sound treatment options. Discussing biochemistry in a person-centred way is important to help patients feel empowered and included in the decision-making process. Learning objectives After completing all aspects of this programme, you should be able to: ■ ■ interpret biochemistry results associated with AKI ■ ■ use relevant biochemistry results to develop appropriate recommendations for medicines optimisation in patients with AKI ■ ■ take a person-centred approach when discussing biochemistry results. A CPPE Optimise programme: Biochemistry Focus on acute kidney injury Getting prepared Lead writer: Anne Waddington, advanced clinical pharmacist, renal medicine, Aintree University Hospital Aim to understand the patient’s experience – task Anyone can develop AKI. Michael was fit and well before – read his story: http://bit.ly/2vJNDPP Ensure medicines use is as safe as possible – task ■ ■ Read the information from NHS Scotland on stopping certain medicines when patients are at risk of dehydration: http://bit.ly/2w87Lfi Think Kidneys recommends that this advice is now called sick day guidance. Read the first two sections (What should I know to manage a person with acute kidney injury? and Staging of acute kidney injury) of the NICE clinical knowledge summary: https://cks.nice.org.uk/ acute-kidney-injury#!scenario Make some notes or print a copy for the small group learning session. Make medicines optimisation part of routine practice - task Think about the last time you recommended a patient stopped taking their medicines due to AKI (either directly or via the prescriber). How did you use biochemistry results to aid your decision-making? Improved patient outcomes Optimised AKI management will see: ■ ■ fewer patients requiring acute renal replacement therapy ■ ■ reduced hospital admissions, length of stay and deaths ■ ■ improved relationships with patients ■ ■ improved patient confidence ■ ■ increased patient involvement in their care ■ ■ reduced risk of complications of impaired renal function, eg, hyperkalaemia. Evidence-based choice of medicines – task Look at Think Kidneys’ medicines optimisation guide: http://bit.ly/2xapdg9 Print a copy for the small group learning session.