PI left the institution & this is not an applicable clinical trial (ACT).

The purpose of this study is to evaluate the effects of pharmaceutical care interventions in the ambulatory hemodialysis patients over a one-year period. Cost containment occurs through pharmaceutical care interventions designed to identify and ameliorate drug-related problems (DRPs), improve the cost-effectiveness of therapeutic regimens and prevent hospitalizations.

Approximately 350,000 end-stage renal disease (ESRD) patients in the United States utilized over $17.9 billion Medicare dollars in 1999. The ESRD population and cost is projected to double by 2010. ESRD patients have a mean of 5 comorbidities per patient and are prescribed a median of eight medications. The average monthly medication cost per patient is approximately $1,200.00. For every dollar spent on medication an additional $1.77 is spent on drug-related problems (DRPs). Dialysis patients are at high risk for DRPs. It is unknown if continued pharmacist intervention in hemodialysis patients will improve patient care, reduce medication utilization and cost, and prevent hospitalization as seen in other populations. The purpose of this study is to investigate the impact of continued pharmacist intervention in ambulatory hemodialysis patients.

Inclusion Criteria:

• Patients are eligible for inclusion in the study if they have been on HD for greater than three months, greater than 18 years of age, those who plan to be continuously enrollment in therapy at the same dialysis center throughout the duration of the study. Informed consent will be obtained on eligible patients. The study is to be approved by the Human Research Review Committee prior to initiation.

Exclusion Criteria:

• Patients will be excluded if they have been on HD for less than three months, decline the opportunity to participate, or are less than 18 years of age.