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KMID : 0941820160260040318
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Korean Journal of Clinical Pharmacy
2016 Volume.26 No. 4 p.318 ~ p.323
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Clinical Outcomes of Multidisciplinary Team Care on the Regulation of Chronic Kidney Disease - Mineral and Bone Disorder (CKD-MBD) in Patients Undergoing Dialysis
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Han Na-Young
Lee Sang-Min
Hong Jin-Yi
Noh Hye-Jin
Ji Eun-Hee
Song Yun-Kyoung
Song Jee-Youn
Kim In-Wha
Kim Yon-Su
Oh Jung-Mi
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Abstract
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Background: Multidisciplinary team care (MTC) is a collaborative approach to treatment plan and ongoing care. We aimed to evaluate the clinical effect of MTC on the regulation of chronic kidney disease-mineral and bone disorder (CKD-MBD)
complications in dialysis patients.
Methods: This retrospective observational study was approved by the institutional review board. Among patients who have undergone dialysis at admission, the patients admitted to the nephrology ward were allocated to MTC group, and the others to usual care (UC) group. The MTC group had collaborative care by nephrologists, nurses, pharmacists, and
nutritionists. The endpoints were the regulation of corrected calcium (cCa) and phosphate (P), the percent of patients in target level of cCa-P product (cCa×P), and the prescription rate of non-calcium based P-binders.
Results: A total of 163 patients were included from January to December 2009. A significant difference was shown in the percentage of patients in target cCa×P level at admission (MTC vs. UC, 81.40% vs. 91.67%; P = 0.038), but there was no significant difference at discharge. During admission, the cCa and P levels of patients in only UC group were significantly changed. In addition, compared with UC group, patients in MTC group were more likely prescribed appropriate P-binders, when they had higher cCa×P levels than 55 mg2/dL2 (P <0.001).
Conclusion: It was found that MTC had beneficial effect on improving the regulation of CKD-MBD and the appropriate phosphate binder uses. Therefore, application of the MTC is anticipated to enhance quality of clinical care in chronic diseases.
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KEYWORD
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Multidisciplinary team care , clinical pharmacist , chronic kidney disease , mineral and bone disorder , clinical outcome
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