Pharmacist-led intervention in pre-dialysis chronic kidney disease: A systematic review and meta-analysis

Context: Chronic kidney disease (CKD) imposes a significant global healthcare burden. Pharmacist-led interventions have been proposed to improve pre-dialysis CKD management, yet comprehensive quantitative evidence remains limited. Aims: To evaluate the effects of pharmacist-led interventions on clinical outcomes, medication adherence, patient knowledge, and drug-related problems (DRPs) in adults with pre-dialysis CKD. Methods: A systematic search of PubMed, Scopus, Web of Science, and Crossref (2010–2024) was conducted in accordance with preferred reporting items for systematic reviews and a meta-analysis (PRISMA) guideline. Eligible randomized controlled trials (RCTs) and quasi-experimental studies were included. Meta-analysis was performed using RevMan 5.4.1. Results: Twelve studies (4,945 patients) were included. Pharmacist-led interventions significantly reduced DRPs (mean difference: -0.23; 95% CI: -0.37 to -0.08; p=0.002) and improved patient knowledge (mean difference: 0.80; 95% CI: 0.64–0.95; p