The Impact of Pharmaceutical Care on Infection Control Measures Among Hemodialysis Patients. A Randomized Interventional Study

Purpose: This study seeks to highlight the impact of clinical pharmacists in protecting hemodialysis patients from catheter-related infections. By ensuring appropriate antimicrobial use, guiding patients on prevention practices, and collaborating with the healthcare team. This study also examines how pharmacists improve safety, treatment adherence, and quality of life. Patients and Methods: This randomized interventional study was conducted between November 2024–April 2025. Patients were divided into intervention and non-intervention groups. The care bundle comprised culture-guided antibiotic locks (except gentamicin–heparin), in-hospital exit-site dressing with 3M Tegaderm by trained staff, and safety medication checks (e.g, blood-pressure monitoring before the use of erythropoiesis-stimulating agents) were used. The primary endpoint was the incidence of catheter-related bloodstream infections (CRBSIs); secondary endpoints were length of stay, admissions, ICU admissions, catheter replacements, and death. Monthly averages of vitals, drug therapy problems (DTPs), and laboratory parameters were obtained for both groups. Results: A total of ninety patients included in this study. The patients were randomly assigned to either the intervention or non-intervention group and a total 81 out of 90 patients successfully completed the study. After four visits and six months of implementing infection control measures within the context of pharmaceutical care, the infection rate showed a significant reduction in the intervention group (from 0.64± 0.48 to 0.20± 0.4, p =0.0001) compared with the non-intervention group (0.66± 0.48 to 0.71± 0.45, p =0.9731). The mean differences increased over time, reaching 0.26 (95% CI of diff.= 0.09 to 0.43) at visit 1, 0.41 (95% CI of diff.= 0.24 to 0.58) at visit 3, and 0.51 (95% CI of diff.= 0.34 to 0.68) at visit 4. Conclusion: Clinical pharmacist intervention via implementing infection control within the context of a pharmaceutical-care process can improve infection rates among hemodialysis patients. Keywords: hemodialysis, CRBSI, tunneled catheter, arteriovenous fistula, antibiotic lock, Tegaderm, CKD, ESA, pharmaceutical care