The impact of improving education about OTC medications for diabetic patients.

Physician assistants in the Phoenix Veterans Administration Health Care System (PVAHCS) undertook a process improvement project addressing the need for over-the-counter (OTC) medication counseling for diabetic patients. Within the framework of the Kidneys-in-a-Box (KIB) program, published by the National Academy of Nephrology PAs, participants examined current practices for the six modifiable factors outlined in the National Kidney Disease Education Program (NKDEP) of the National Institutes of Health (NIH). Chart review by PVAHCS found a significant lack in OTC medication education, with less than 10% of reviewed patients having been counseled on medications that may affect kidney function. OTC medication counseling and distribution of a brochure developed for the project were implemented over a three-month time frame in the daily practices of the participating PAs and the PVAHCS Nephrology Clinic. Post project chart review of 110 patient records found a statistically significant increase in patient education (50.9%). While the change in PA behavior is significant, the goal of the project moving forward is to show impact on incidence of acute kidney injury (AKI) in the diabetic veteran population.