title: Assessing the implementability of clinical pharmacist interventions in patients with chronic kidney disease: an analysis of systematic reviews.
abstract: BACKGROUND
  Pharmacy practice studies have been criticized for presenting poor intervention description, which has serious implications when attempting to replicate interventions elsewhere. Evidence of improved outcomes for patients with chronic kidney disease (CKD) following pharmacist intervention exist in the literature, but similar concerns with intervention description have been raised.
  
  
  OBJECTIVE
  To assess the implementability of evidence-based clinical pharmacist interventions in patients with CKD, based on the information contained in the published manuscripts.
  
  
  METHODS
  PubMed was searched to retrieve systematic reviews addressing the role of pharmacists in patients with CKD. Primary studies describing clinical pharmacy services in CKD were subsequently extracted. To describe and characterize pharmacists' interventions, the DEPICT (Descriptive Elements of Pharmacist Intervention Characterization Tool) was applied. Studies were independently classified as "implementable" or "nonimplementable" by 2 authors, based on whether they could be easily implemented into practice using the description provided in the article. Finally, implementable interventions were grouped in different areas.
  
  
  RESULTS
  Five reviews were retrieved, and 39 original studies were analyzed. Of these, 59.0% were classified as nonimplementable. Among implementable interventions, 6 evidence-based areas of pharmacist interventions were identified: anemia, renal osteodystrophy, and cardiovascular risk factors management, medication appropriateness evaluation and medication reconciliation, patient education and compliance, and cost containment.
  
  
  CONCLUSIONS
  Information contained in most articles reporting pharmacist interventions in CKD is not sufficient to ensure the implementation of the service in clinical practice. Pharmacy practice research articles should be written with the aim of improving clinical practice and not just showing the results of pharmacists' interventions.
authors.affiliation: Research Institute for Medicines and Pharmaceutical Sciences (iMed.UL), University of Lisbon, Portugal.
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Salgado
authors.forename: Cassyano J
authors.initials: CJ
authors.lastname: Correr
authors.forename: Rebekah
authors.initials: R
authors.lastname: Moles
authors.forename: Shalom I
authors.initials: SI
authors.lastname: Benrimoj
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernandez-Llimos
mesh_terms: D006801:Humans; D010349:Patient Compliance; D010353:Patient Education as Topic; D010595:Pharmacists; D010607:Pharmacy Service, Hospital / Q000379:methods*; D024382:Professional Role; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy*
keywords: chronic kidney disease; clinical pharmacy services; evidence-based practice; pharmacist interventions