Clinical pharmacy services to improve management outcomes of Chronic Kidney Disease of uncertain etiology

INTERVENTION: The study subjects will be recruited from the patients diagnosed with CKDu Stages 4 and 5, attending out‐patient renal clinics in Teaching Hospital, Anuradhapura. The randomization will be done using the closed envelope method to allocate the participants into two arms. A trained Sri Lankan pharmacist will provide the following clinical pharmacy services to the participants in the intervention arm during four non‐consecutive clinic visits over a period of one year (at recruitment and 2,6 and 10 months) 1. Individual review of the patients’ drug list (Possible drug related problems will be communicated to the doctor or patient depending on its nature). 2. Individualized one to one drug counselling for 30 minutes. The non‐intervention group will receive standard clinic care. CONDITION: Chronic Kidney Disease of uncertain etiology PRIMARY OUTCOME: Drug adherence as measured by the brief medication questionnaire: A tool for screening patient adherence and barriers to adherence (Svarstad et al., 1999) SECONDARY OUTCOME: 1. Blood Pressure ; 2. Blood investigations: hemoglobin, serum calcium, serum phosphate, serum creatinine, serum electrolytes ; 3. Quality of life as measured by Kidney Disease Quality of Life Short Form (KDQOL‐SFTM), Version 1.3. (Hays et al, 1995). ; INCLUSION CRITERIA: 1. Consenting adults age over 18 years 2. Established diagnosis of Stage 3 or 4 Chronic Kidney Disease of Uncertain etiology