Start With Why: Framing CKM Meds for Patient Buy-In

In an interview with Pharmacy Times, Andrew Bzowyckyj, PharmD, BCPS, CDCES, FADCES, FAPhA, FCCP, senior scientific director and learning consultant at the National Kidney Foundation, discussed the pharmacist’s role in earlier cardiovascular-kidney-metabolic (CKM) risk stratification and how the inflammation signal should shape patient counseling. These insights were garnered from a presentation he delivered at the 2026 Association of Diabetes Care and Education Specialists (ADCES) Annual Meeting in Columbus, Ohio, titled “Decoding CKM Through Three Key Signals: Kidney, Heart, and Inflammation.”

Within a team-based care model, he said, pharmacists can leverage the existing electronic health record to look for and, where it fits their scope or is clinically indicated, recommend key tests—identifying which parts of the risk puzzle are missing. He urged the field to move beyond A1C in diabetes care toward a broader CKM view and singled out closing the urine albumin-to-creatinine ratio (UACR) testing gap as a high-value target, given that UACR is a quantifiable, modifiable measure tied to a Healthcare Effectiveness Data and Information Set quality metric and to guideline recommendations in both diabetes and hypertension. Protocols, standing orders, and recommendations can all help drive testing in high-risk patients.

Interpreting results and translating them into patient education is equally important, Bzowyckyj said, including explaining heart failure with preserved versus reduced ejection fraction (HFpEF vs HFrEF) in plain terms. On inflammation specifically, he described high-sensitivity C-reactive protein (HS-CRP) as a more nebulous, non-routine test that acts as a risk magnifier in clinically ambiguous situations, such as an indeterminate risk score or a coexisting inflammatory condition like rheumatoid arthritis, and as a motivating data point for patients ambivalent about statins or smoking cessation. He also noted that many CKM therapies, including glucagon-like peptide-1 receptor agonists, sodium glucose transporter-2 inhibitors, colchicine (Lodoco; AGEPHA Pharma), and metformin, carry anti-inflammatory effects, giving pharmacists a way to frame systemic inflammation as the “slow burn” that links these conditions. Invoking Simon Sinek’s “start with why,” he emphasized that showing patients the rationale drives engagement.