***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives To be useable in clinical practise , treatments studied in trials must provide sufficient information to enable clinicians and research ers to replicate . We sought to assess the completeness of treatment descriptions in published r and omised controlled trials ( RCTs ) using a checklist and to determine the extent to which peer review ers and editors comment on the quality of reporting of treatments . Design A cross-sectional study . Setting Trials published in the BMJ , a general medical journal . Participants Fifty-one trials published in the BMJ were independently evaluated by two raters using a checklist . Review ers ’ and editors ’ comments were also assessed for statements on treatment descriptions . Primary and secondary outcome measures Proportion of trials rated as replicable ( primary outcome ) . Results For 57 % ( 29/51 ) of the papers , published treatment descriptions were not considered sufficient to allow replication . Most poorly described aspects were the actual procedures involved including the sequencing of the technique ( what happened and when ) and the physical or informational material s used ( eg , training material s ) : 53 % and 43 % not clear , respectively . For a third of treatments , the dose/ duration of individual sessions was not clear and for a quarter the schedule ( interval , frequency , duration or timing ) was not clear . Although the majority of problems were not picked up by review ers and editors , when they were detected only about two-thirds were fixed before publication . Conclusions Journals wanting to publish the research of use to practising healthcare professionals need to pay more attention to descriptions of treatments . Our checklist , may be useful for review ers , and editors and could help ensure that important details of treatments are provided before papers are in the public domain Background In France , community pharmacists do not have free access to patients ’ lab results , and it is therefore impossible for them to identify patients with renal impairment . Objective ( 1 ) to evaluate the ability of community pharmacists ( CPs ) to identify drug related problems ( DRP ) in patients at risk for or suffering from renal impairment ; ( 2 ) to evaluate the proportions of recommendations by CPs that lead to a modification by GP . Setting A prospect i ve and observational study involving 24 community pharmacists in France . Methods Following special training , community pharmacists were asked to select 52 patients with the following characteristics : ≥65 years of age ; prescribed at least two diabetic and /or antihypertensive drugs . Serum creatinine value was obtained for each patient and glomerular filtration rate estimated ( eGFR ) with the aMDRD formula . Those with a eGFR 60 ml/min/1.73 m² were considered having chronic kidney disease ( CKD ) . Data was collected concerning whether the community pharmacists identified drug related problems and tried to inform the GP who prescribed the medications . Identified DRP were review ed by a team of nephrologists and hospital clinical pharmacists . Primary outcome The proportion of CKD patients and those without serum creatinine monitoring , the number of drug related problems identified by community pharmacists , and the proportion of drug related problems resolved by the community pharmacists intervention to the GP . Results Of the total 791 patients identified , 180 ( 22.8 % ) exhibited CKD , and 57 ( 7.2 % ) had not undergone serum creatinine monitoring . Among the 1297 drugs prescribed , 260 had to be adapted to eGFR . The proportion of DRP was 21.5 % ( 56/260 ) , of which 40 % ( 20 ) were identified by community pharmacists . Once the GP was informed , 33.3 % ( 6/18 ) of DRP were resolved . Conclusion Community pharmacists identified 40 % of DRP related to CKD prescriptions , leading to prescription modification by GPs in a third of the cases . These interventions are likely to decrease drug-related morbidity and mortality BACKGROUND AND OBJECTIVES CKD is characterized by remarkably high hospitalization and readmission rates . Our study aim was to test a medication therapy management intervention to reduce subsequent acute care utilization . DESIGN , SETTING , PARTICIPANTS , & MEASUREMENTS The CKD Medication Intervention Trial was a single-blind ( investigators ) , r and omized clinical trial conducted at Providence Health Care in Spokane , Washington . Patients with CKD stages 3 - 5 not treated by dialysis who were hospitalized for acute illness were recruited . The intervention was design ed to improve posthospitalization care by medication therapy management . A pharmacist delivered the intervention as a single home visit within 7 days of discharge . The intervention included these fundamental elements : comprehensive medication review , medication action plan , and a personal medication list . The primary outcome was a composite of acute care utilization ( hospital readmissions and emergency department and urgent care visits ) for 90 days after hospitalization . RESULTS Baseline characteristics of participants ( n=141 ) included the following : age , 69±11 ( mean±SD ) years old ; women , 48 % ( 67 of 141 ) ; diabetes , 56 % ( 79 of 141 ) ; hypertension , 83 % ( 117 of 141 ) ; eGFR , 41±14 ml/min per 1.73 m2 ( serum creatinine-based Chronic Kidney Disease Epidemiology Collaboration equation ) ; and urine albumin-to-creatinine ratio median , 43 mg/g ( interquartile range , 8 - 528 ) creatinine . The most common primary diagnoses for hospitalization were the following : cardiovascular events , 36 % ( 51 of 141 ) ; infections , 18 % ( 26 of 141 ) ; and kidney diseases , 12 % ( 17 of 141 ) . The primary outcome occurred in 32 of 72 ( 44 % ) of the medication intervention group and 28 of 69 ( 41 % ) of those in usual care ( log rank P=0.72 ) . For only hospital readmission , the rate was 19 of 72 ( 26 % ) in the medication intervention group and 18 of 69 ( 26 % ) in the usual care group ( log rank P=0.95 ) . There was no between-group difference in achievement of guideline -based goals for use of renin-angiotensin system inhibition or for BP , hemoglobin , phosphorus , or parathyroid hormone . CONCLUSIONS Acute care utilization after hospitalization was not reduced by a pharmacist-led medication therapy management intervention at the transition from hospital to home OBJECTIVES The objectives of this study were to determine if hypertensive patients with comorbid diabetes mellitus ( DM ) and /or chronic kidney disease ( CKD ) receiving a pharmacist intervention  had a greater reduction in mean blood pressure ( BP ) and improved BP control at 9 months compared with those receiving usual care ; and compare Seventh Report of the Joint National Committee on Prevention , Detection , Evaluation , and Treatment of High Blood Pressure ( JNC 7 ) guideline and 2014 guideline ( JNC 8) BP control rates in patients with DM and /or CKD . METHODS This cluster r and omized trial included 32 medical offices in 15 states .  Clinical pharmacists made treatment recommendations to physicians at intervention sites . This post hoc analysis evaluated mean BP and BP control rates in the intervention and control groups . MAIN RESULTS The study included 335 patients ( 227 intervention , 108 control ) when  mean BP  and control rates were evaluated by JNC 7 inclusion and control criteria . When JNC 8 inclusion and control criteria were applied , 241 patients ( 165 intervention , 76 control ) remained and were included in the analysis . The pharmacist-intervention group had significantly greater mean systolic blood pressure reduction compared with usual care at 9 months ( 8.64 mm Hg ; 95 % confidence interval [ CI ] -12.8 to -4.49 , p<0.001 ) . The pharmacist-intervention group had significantly higher BP control at 9 months than usual care by either the JNC 7 or JNC 8 inclusion and control groups ( adjusted odds ratio [ OR ] 1.97 , 95 % CI 1.01 - 3.86 , p=0.0470 and OR 2.16 , 95 % CI 1.21 - 3.85 , p=0.0102 , respectively ) . PRINCIPAL CONCLUSIONS This study demonstrated that a physician-pharmacist collaborative intervention was effective in reducing mean systolic BP and improving BP control in patients with uncontrolled hypertension with DM and /or CKD , regardless of which BP guidelines were used BACKGROUND Appropriate antimicrobial dosing for patients receiving continuous venovenous hemofiltration ( CVVH ) is complex . Pharmacist participation in antimicrobial dosing adjustment for patients receiving CVVH may be advantageous . METHODS A comparative study was performed in a China hospital intensive care unit ( ICU ) . Patients receiving CVVH in the intervention group received antimicrobial dosing adjustment service by pharmacists from January 2012 to June 2012 , whereas patients in the control group received routine medical care between July 2012 and December 2012 . The primary outcomes including patients ' length of ICU stay , mortality in ICU , ICU hospitalization costs , and the occurrence of adverse drug events ( ADEs ) were then compared . RESULTS 87 and 93 patients were included in the control and intervention groups . During the intervention period , pharmacists made 256 antimicrobial dosing adjustment recommendations for 93 enrolled patients receiving CVVH , of which 224 ( 87.5 % ) recommendations were accepted by physicians . Changing in CVVH-related variables ( 175 , 68.4 % ) were the most common risk factors for dosing errors , whereas β-lactams ( 131 , 51.2 % ) were the most frequency of antimicrobials associated with dosing errors . Compared with the control group , pharmacist dosing adjustment result ed in £ 1637.7 cost savings per patient , and 2.36 times reduction of antimicrobial-related adverse drug events ( ADEs ) ( 11 vs 26 , P=0.002 ) , while length of ICU stay and mortality in ICU showed no significant difference ( P>0.05 ) . CONCLUSIONS The involvement of pharmacist to participate in the ICU team rounds for patients receiving CVVH is associated with cost savings and reduction of ADEs . Hospital may consider employing ICU pharmacists Background Drug dosing errors are common in renal-impaired patients . Appropriate dosing adjustment and drug selection is important to ensure patients ’ safety and to avoid adverse drug effects and poor outcomes . There are few studies on this issue in community pharmacies . The aims of this study were , firstly , to determine the prevalence of dosing inadequacy as a consequence of renal impairment in patients over 65 taking 3 or more drug products who were being attended in community pharmacies and , secondly , to evaluate the effectiveness of the community pharmacist ’s intervention in improving dosing inadequacy in these patients when compared with usual care . Methods The study was carried out in 40 Spanish community pharmacies . The study had two phases : the first , with an observational , multicentre , cross sectional design , served to determine the dosing inadequacy , the drug-related problems per patient and to obtain the control group . The second phase , with a controlled study with historical control group , was the intervention phase . When dosing adjustments were needed , the pharmacists made recommendations to the physicians . A comparison was made between the control and the intervention group regarding the prevalence of drug dosing inadequacy and the mean number of drug-related problems per patient . Results The mean of the prevalence of drug dosing inadequacy was 17.5 % [ 95 % CI 14.6 - 21.5 ] in phase 1 and 15.5 % [ 95 % CI 14.5 - 16.6 ] in phase 2 . The mean number of drug-related problems per patient was 0.7 [ 95 % CI 0.5 - 0.8 ] in phase 1 and 0.50 [ 95 % CI 0.4 - 0.6 ] in phase 2 . The difference in the prevalence of dosing inadequacy between the control and intervention group before the pharmacists ’ intervention was 0.73 % [ 95 % CI ( −6.0 ) - 7.5 ] and after the pharmacists ’ intervention it was 13.5 % [ 95 % CI 8.0 - 19.5 ] ( p < 0.001 ) while the difference in the mean of drug-related problems per patient before the pharmacists ’ intervention was 0.05 [ 95 % CI ( -0.2 ) - 0.3 ] and following the intervention it was 0.5 [ 95 % CI 0.3 - 0.7 ] ( p < 0.001 ) . Conclusion A drug dosing adjustment service for elderly patients with renal impairment in community pharmacies can increase the proportion of adequate drug dosing , and improve the drug-related problems per patient . Collaborative practice with physicians can improve these results INTRODUCTION The number of patients suffering from chronic kidney disease ( CKD ) is increasing worldwide . Hyperphosphataemia and high serum calcium ( Ca ) and phosphorus ( P ) product contribute to the substantial increase in cardiovascular events in CKD patients . Although reports of CKD complications in Iranian haemodialysis ( HD ) patients are comparable to data from other developed countries , management of these complications has failed to meet generally accepted targets . This study evaluated the impact of clinical pharmacy services in the management 
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Positive impact on clinical outcomes included significant improvement in parathyroid hormone , blood pressure , haemoglobin and creatinine clearance .
Impact on humanistic outcomes was shown through improvement in health related quality of life and patient satisfaction .
Economic benefits arose from significant cost savings through pharmaceutical care provision .