Abstract: TH-PO0492
Optimizing Medication Safety for Patients with ESKD Through Point-of-Verification Clinical Evaluations
Session Information
- Dialysis: Novel Therapeutics and Medication Management
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Martinez, Amanda J, FreseniusRx, Franklin, Tennessee, United States
- Kutovoy, Gennady, FreseniusRx, Franklin, Tennessee, United States
- Grissom, Peyton Hancock, FreseniusRx, Franklin, Tennessee, United States
Background
Patients with ESKD face a high medication burden and are at increased risk for medication-related problems (MRPs). Traditional outpatient pharmacy models often lack the clinical oversight needed to address these risks. An integrated renal mail-order pharmacy implemented a point-of-verification process using a clinical algorithm to identify medications requiring renal dose adjustment (RDA) or considered potentially inappropriate (PI), triggering pharmacist-led clinical medication evaluations (CME). This study evaluated the effectiveness of CME in identifying and resolving MRPs.
Methods
This retrospective analysis included ESKD patients enrolled in pharmacy services from 2/13/23 to 2/13/25. Medications flagged for RDA or PI were isolated at verification for pharmacist CME. Pharmacists conducted patient-specific reviews, intervened on MRPs, and communicated recommendations to prescribers. Intervention acceptance rates, time to resolution, and most frequently reviewed medications were tracked using descriptive statistics.
Results
Among 5,827 patients, 11,390 prescriptions underwent point-of-verification CME. The study population was predominantly male (52.4%), white (48.2%), undergoing in-center hemodialysis (68%) and covered by managed Medicare (48.9%). Interventions were required for 3,271 prescriptions, primarily for RDA (n=2,446). The top 10 medications requiring intervention are included in Table 1. The overall intervention acceptance rate was 69.4%, with an average resolution time of 3 business days.
Conclusion
Point-of-verification CME within an integrated renal mail-order pharmacy effectively identified and resolved MRPs in patients with ESKD. This model demonstrates a scalable approach to improving medication safety through pharmacist-led interventions.
Top 10 Medications
| Drug | Total | % of Total Recommendations | |
| 1 | Rosuvastatin | 411 | 15.0% |
| 2 | Famotidine | 384 | 14.0% |
| 3 | Apixaban | 186 | 6.8% |
| 4 | Cetirizine | 165 | 6.0% |
| 5 | Loratadine | 115 | 4.2% |
| 6 | Chlorthalidone | 96 | 3.5% |
| 7 | Spironolactone | 89 | 3.3% |
| 8 | Colchicine | 87 | 3.2% |
| 9 | Hydrochlorothiazide | 84 | 3.1% |
| 10 | Bupropion | 71 | 2.6% |