Impact of Telepharmacy on Hemodialysis Outcomes

NCT07889102 — Not applicable, Completed, 101 participants, Damanhour University

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Effect of Telepharmacy on Clinical and Economic Outcomes in Hemodialysis Patients: A Randomized Controlled Trial

Registry	NCT07889102
Status	Completed
Phase	Not applicable
Study type	Interventional; randomized, parallel, masking: none, supportive care
Enrollment	101 (Actual)
Sponsor	Damanhour University (Other)
Conditions	Anemia, Hemodialysis
Interventions	Routine Standard Care, Telepharmacy Intervention (Other, behavioral)
Dates	start 2024-12-01, primary completion 2025-04-01, completion 2025-04-30, first posted 2026-10-22, last updated 2026-10-22
Locations	2 sites in Egypt

-Summary

This study looked at whether regular follow-up by pharmacists through phone calls (telepharmacy) can help improve the treatment of anaemia in patients undergoing haemodialysis.

Anaemia is very common in patients with kidney disease and can cause fatigue, weakness, and an increased risk of heart problems. It is usually treated with medications such as erythropoietin (EPO), but managing the correct dose and ensuring patients follow treatment can be challenging. In this study, patients were divided into two groups. One group received standard care, while the other group received additional support from pharmacists through regular phone calls. During these calls, pharmacists helped patients understand their medications, encouraged adherence, monitored symptoms, and worked with doctors to adjust treatment when needed.

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+Arms and interventions

Arm	Type	Interventions	Description
Standard Care Control Group	Active comparator	Other: Routine Standard Care	Participants assigned to this arm received routine hemodialysis care according to standard clinical practice without additional telepharmacy support. This included regular physician follow-up, laboratory monitoring, and medication management as determined by the treating healthcare team. No structured pharmacist-led remote monitoring or scheduled telecommunication-based interventions were provided.
Telepharmacy Intervention Group	Experimental	Other: Routine Standard Care; Behavioral: Telepharmacy Intervention	Participants assigned to this arm received routine maintenance hemodialysis care in addition to a structured telepharmacy intervention delivered by trained clinical pharmacists over a 5-month period. The intervention included scheduled telephone follow-up, medication review, adherence assessment, individualized counseling, monitoring of laboratory results, identification and resolution of drug-related problems, and collaboration with treating physicians to optimize erythropoiesis-stimulating agent (ESA) therapy and overall medication management.

Routine Standard Care (Other): Participants assigned to the Routine Standard Care intervention received routine maintenance hemodialysis care according to the participating hospitals' standard clinical practice. Standard care included regular nephrologist follow-up, routine laboratory monitoring (including hemoglobin and other relevant biochemical parameters), prescription and adjustment of erythropoiesis-stimulating agents (ESAs) and other medications as clinically indicated, and conventional nursing and dialysis care. Medication management and treatment decisions were made during routine clinical visits. Unlike the experimental arm, participants did not receive the structured telepharmacy intervention, including scheduled telephone consultations, proactive medication review, adherence counseling, pharmacist-initiated remote monitoring, or pharmacist-led therapeutic follow-up.
Telepharmacy Intervention (Behavioral): Pharmacist-led remote care including scheduled telephone follow-up, medication review, adherence assessment, individualized counseling, monitoring of laboratory results, identification and resolution of drug-related problems, and collaboration with physicians to optimize erythropoiesis-stimulating agent (ESA) therapy and overall medication management. Participants continued to receive routine standard care throughout the study in addition to the telepharmacy intervention.

+Outcome measures

Primary outcomes

Change in hemoglobin (Hb) level [5 months]

Secondary outcomes

Change in erythropoietin dose [5 months]

Other outcomes

Number of identified drug-related problems [5 months]

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Adults aged 18 years or older.
* Confirmed diagnosis of chronic kidney disease (CKD).
* Receiving maintenance hemodialysis at one of the participating centers.
* Receiving regular hemodialysis sessions.
* Anemia requiring treatment with erythropoiesis-stimulating agents (ESAs).
* Baseline hemoglobin level <11.5 g/dL.
* Able to communicate by telephone to participate in the telepharmacy intervention.
* Willing and able to provide written informed consent.
* Willing to comply with all study procedures and follow-up assessments.

Exclusion Criteria:

* Unwilling or unable to provide informed consent.
* Significant cognitive impairment or psychiatric illness that could interfere with study participation.
* No reliable telephone access for telepharmacy follow-up.
* Unstable clinical condition requiring emergency or intensive care.
* Severe comorbid conditions expected to limit short-term survival.
* Not receiving regular maintenance hemodialysis.
* Incomplete baseline clinical or laboratory data.
* Inability or unwillingness to complete the planned follow-up period

+Locations (2)

Facility	City	Country	Status
Menoufia University Hospital	Shibīn al Kawm, Menofia	Egypt
Menoufia University Hospital	Shibīn al Kawm, Menoufia	Egypt