TOPLINE:

Spanish community pharmacies identified potentially inappropriate prescriptions requiring physician notification in 41.9% of patients with an estimated glomerular filtration rate (eGFR) lower than 60 mL/min/1.73 m², and changes were implemented in 3.4% of the medications reviewed.

METHODOLOGY:

• Researchers conducted a study to assess the feasibility of community pharmacies in detecting potentially inappropriate prescriptions in patients with a reduced eGFR.
• They included 670 patients (mean age, 72.5 years; 49.9% women) from 16 Spanish community pharmacies, all of whom were taking at least one nephrotoxic drug or a medication requiring dose adjustment on the basis of the eGFR.
• A point-of-care creatinine test was conducted for those without an eGFR measurement in the previous 3 months, and the eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration formula.
• A total of 1670 medications for 215 patients with an eGFR below 60 mL/min/1.73 m² were reviewed to identify contraindicated or inappropriately dosed drugs.
• Reports of potentially inappropriate prescriptions were generated and sent to primary care physicians.

TAKEAWAY:

• Among the 215 patients, 90 (41.9%) had at least one potentially inappropriate prescription.
• Patients with at least one potentially inappropriate prescription were taking significantly more medications than those on an appropriate treatment regimen (mean, 9.1 vs 6.8 drugs per patient; P < .0001).
• Of the 1670 medications reviewed, pharmacists proposed 150 changes for 90 patients, of which 57 (38%) were implemented, representing 3.4% of all the medications evaluated.
• The proportion of potentially inappropriate prescriptions increased with the severity of chronic kidney disease: 27.8% in stage 3a, 55.4% in stage 3b, and 93.3% in stage 4 (P < .0001).

IN PRACTICE:

"Community pharmacies can play a crucial role in optimizing medication management for patients with reduced glomerular filtration rates by reviewing their prescriptions to identify potentially inappropriate prescriptions," the authors wrote.

SOURCE:

This study was led by Gema Escribá-Martí, Community Pharmacist, Segart, Valencia, Spain. It was published online on October 14, 2025, in PLoS One.

LIMITATIONS:

This study lacked a control group. Additionally, the lack of direct communication with primary care physicians significantly contributed to the low implementation rate of the proposed medication changes.

DISCLOSURES:

This study did not receive any specific funding. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.