Original Research
Tuesday, October 15, 2024
08:30 AM–10:00 AM
Abstract
Introduction: Electronic medical records (EMRs) play a crucial role in clinical decision making. However, optimal reporting of estimated glomerular filtration rate (eGFR) within EMRs remains a challenge.
Research Question or Hypothesis: We aimed to describe eGFR reporting in EMRs and any associated challenges.
Study Design: We conducted a cross-sectional survey study.
Methods: An anonymous survey about eGFR reporting within EMRs was created and shared through listservs used by pharmacists nationally and internationally. Data are reported using descriptive statistics.
Results: Of 293 respondents, 76% were from the United States and the remainder represented 18 other countries. Most practiced in inpatient settings across a variety of specialties with a mean of 13.4 ± 9.1 years of experience. Cockcroft Gault (CG) was the primary kidney function estimation equation in 45% of EMRs and 25% reported CKD-EPI, of which 44% reported uncertainty of the specific equation used. Information on eGFR was predominantly found within lab results (51%), with only 22% accessible from the main screen and 14% during order entry/verification. Dissatisfaction with eGFR presentation in the EMR was noted by 29% of respondents. Identified challenges include transparency regarding kidney replacement therapy (35%), unclear/inappropriate patient parameters in estimation equations (36%), and visibility issues (14%). About 55% felt the eGFR calculations in the EMR were reliable for medication-related decision-making, although 82% reported no training on interpretation of eGFR results. Respondents favored institution-specific kidney dosing guidance (about 50% of respondents) more than commercially derived guidance (39%). Areas for opportunity include improved clarity (24%), visibility (31%), integration of patient data (27%), and built-in guidance (17%).
Conclusion: Our study sheds light on the current landscape of eGFR reporting within EMRs. Access, accuracy, and education are major concerns. Optimization of eGFR reporting and access and training on interpretation of eGFR results within EMRs are areas for potential intervention to better inform medication-related decisions.
Presenting Author
Lisa Hong PharmD, BCPSLoma Linda University
Authors
Erica Anderson PharmD
Atrium Health Wake Forest Baptist Medical Center
Wasim Elnekidy PharmD, BCPS, BCACP
Cleveland Clinic Abu Dhabi
Branden D Nemecek PharmD, BCPS
Duquesne University
Wendy St. Peter Pharm.D.
University of Minnesota College of Pharmacy