Category: Federal Forum Posters
Purpose: Approximately half of all individuals with Type 2 Diabetes Mellitus will develop chronic kidney disease (CKD). CKD is associated with poorer renal and cardiovascular outcomes that have been shown to negatively affect quality and length of life. Clinical pharmacy services have been shown to improve care in various patient populations. Also, agents in the SGLT-2 inhibitor class have shown promise in improving renal outcomes aside from their glycemic benefits in recent evidence. Therefore, our project will pilot the feasibility, safety, and effectiveness of an innovative collaborative care model for empagliflozin initiation in an interprofessional nephrology clinic.
Methods: The pilot project was reviewed by the institution’s Research & Development Committee. Our clinical demonstration was determined to be a quality improvement project and was approved for publication following internal review. A protocol was developed for screening and initiating patients on empagliflozin a priori. Our clinical demonstration includes patients with Type 2 Diabetes Mellitus enrolled in the nephrology clinic at a single center at our institution. Exclusion criteria include hypersensitivity to an SGLT-2 inhibitor, eGFR less than 35ml/min/1.73m2, pancreatitis, history of frequent UTIs, indwelling catheters, need for self-catheterization, or known history of increased post void residual. Eligible patients were identified by the team’s nephrologist and subsequently referred to the Renal Pharmacist for additional screening, counseling, and monitoring. The Renal Pharmacist would follow-up via telephone until the patient has been on empagliflozin 25mg safely for one month. Secondary objectives include change in A1C at three months, change in insulin requirements, adverse event rate, changes in blood pressure, and weight. Other data collected will include demographics, gender, concomitant use renin-angiotensin-aldosterone system inhibitor, diuretics, past medical history, and medication adherence.
Results: not applicable
Conclusion: not applicable
Christopher Fagbote– PGY1 Pharmacy Resident, VA BOSTON HEALTHCARE SYSTEM, West Roxbury, MA