Low rate of pharmacists accessing renal function laboratory values: A cross-sectional study using electronic medical records of a Japanese community pharmacy

Abstract

This study aimed to assess the availability of renal function laboratory values in Japanese community pharmacies and examine their association with the prescription of drugs requiring dosage adjustment. In this cross-sectional observational study, data were obtained from the electronic medical records of a community pharmacy in Japan. A total of 389 eligible patients (aged ≥ 18 years) who visited the pharmacy in April 2024 were included. The primary outcome measures were the proportion of participants with available renal function laboratory values and those prescribed medications requiring dosage adjustment. A total of 128 patients (32.9%) were prescribed at least one medication requiring dosage adjustment, most commonly vitamin A and D preparations (32 cases) and antidiabetic agents (31 cases). Renal function laboratory values were available for 40 patients (10.3%). Compared to those not prescribed such drugs, patients receiving medications requiring renal-based dosage adjustments included a significantly higher proportion of older adults (70/128, 54.7% vs 98/261, 37.5%, p = 0.001) and patients with available laboratory values (20/128, 15.6% vs 20/261, 7.7%, p = 0.015). No patients were identified with the "Triple Whammy," which is known to significantly increase the risk of renal function deterioration. Community pharmacists endeavor to obtain renal function laboratory values for older adults, who are more likely to be prescribed medications requiring dosage adjustment. However, the proportion of cases with obtained laboratory values remains low. Pharmacists are expected to actively recommend renal function testing to physicians. Furthermore, they should contribute to safe pharmacotherapy by utilizing comprehensive patient information.