2025 Southeastern Residency Conference

Title: Evaluation of a Pharmacist-Led Cardiovascular-Kidney-Metabolic (CKM) Initiative 


Objective: To evaluate the impact of a pharmacist-led cardiovascular-kidney-metabolic (CKM) initiative to assist in early detection in management of CKD to slow disease progression and prevent cardiovascular disease. 


Background: In 2023, the American Heart Association (AHA) published a presidential advisory on Cardiovascular- Kidney-Metabolic (CKM) Health, which defines CKM syndrome as a health disorder attributable to connections among obesity, diabetes, chronic kidney disease (CKD), and cardiovascular disease (CVD), including heart failure, atrial fibrillation, coronary heart disease, stroke, and peripheral artery disease. The AHA recommends that patients be screened across their life span with the main aim to reduce the risk of CKD progression and prevent associated cardiovascular outcomes. This wholistic approach includes patient-centered pharmacologic and nonpharmacologic therapy which may include treatment of obesity, diabetes, hypertension, hyperlipidemia, and CKD to reduce cardiovascular disease risk factors. In order to slow progression and prevent associated adverse outcomes of CKM, it requires an interdisciplinary team of nephrology, cardiology, endocrinology, and primary care. However, there are barriers to this wholistic approach which include provider difficulty managing risk factors, provider concerns about adverse drug reactions , patient acceptance, affordability of treatment, and lack of comprehensive integrated clinical information systems. The inclusion of a clinical pharmacist in this multidisciplinary team can help address these barriers to increase the number of patients on guideline-directed therapy with the ultimate goal to reduce CKD and CVD risk in CKM. Pharmacists at our institution have implemented a CKM initiative to assist in early detection in management of CKD to slow disease progression and prevent cardiovascular disease. 


Methods: A single-center retrospective chart review was conducted at Piedmont Columbus Regional Midtown Family Medicine Center and Piedmont Community Health Clinic to evaluate the impact of the pharmacist-led CKM initiative conducted between October 1, 2024, through February 28, 2025. The study included patients screened by clinical pharmacists at Piedmont Columbus Community Health and Piedmont Columbus Family Medicine and excluded patients on renal replacement therapies and renal transplant patients. The primary outcome was the percent of patients receiving CKM screening with an actionable recommendation by the pharmacist [obtainment of a laboratory assessment, addition of guideline directed therapy, adjustment in guideline directed therapy doses, or referral to the pharmacist managed clinic for chronic disease state management (DM, HTN, HLD, CKD, obesity management, smoking cessation)]. Secondary outcomes included percent of patients on guideline-recommended therapies for CKM pre- and post-intervention, percent of patients diagnosed with CKD through screenings, percent of patients with a positive clinical outcome, and number of medications obtained through patient assistance programs. Descriptive statistics were used to analyze the primary objective and both chi-square and descriptive statistics were used to analyze the secondary outcomes.  


Results: In progress


Conclusion: In progress