U.S. clinic survey finds a gap between CKM screening and use of risk tools

A preliminary U.S. clinic survey released by the American Heart Association (AHA) on November 2 points to an implementation problem relevant to pharmacy teams: identifying cardiovascular, kidney and metabolic conditions does not necessarily mean a clinic consistently uses tools to assess the combined risk. The conference research report is a description of practice, not a trial showing that a particular workflow improves patient outcomes.

Key takeaways

• The survey involved selected U.S. clinics, not a representative sample of Canadian practice.
• Screening and formal risk assessment are different activities; a completed test does not guarantee that its result informs a coordinated care plan.
• The findings are preliminary conference research. They should not be presented as a newly proven treatment strategy.

What the survey measured

Ninety-seven clinics from a 150-site initiative responded to a questionnaire conducted between August 2025 and June 2026. About three-quarters reported screening for cardiovascular-kidney-metabolic (CKM) conditions, while 28% reported using PREVENT risk calculations and 22% reported using CKM staging. These are self-reported practices in participating sites; selection and reporting limitations matter. The AHA release also identifies the work as preliminary rather than a peer-reviewed full publication.

Those distinctions change the interpretation. A low reported use of one tool does not establish that a clinic provides no risk assessment, nor does it quantify preventable events. The survey is better treated as a prompt to examine how information moves through a service: who orders a test, who sees the result and who is responsible for acting on it.

The clinical framework is older than this report

The 2026 CKM guideline provides background on the interaction of cardiovascular disease, kidney disease and metabolic risk. It predates this November research report. The new item is the survey of implementation, not the first recognition that these conditions overlap. AHA also maintains professional learning resources on this framework.

For Canadian pharmacists, the appropriate translation is not to copy a U.S. clinic algorithm into local practice without review. It is to check whether information already available during medication care—such as a documented kidney assessment, blood pressure history or a treatment change—reaches the clinician responsible for the broader plan. Local scope, referral pathways and Canadian guidance still govern the service.

Practice guidance for pharmacists

• Look for fragmented follow-up when reviewing medicines for patients with overlapping heart, kidney and metabolic conditions.
• Confirm which clinician is responsible for reviewing relevant laboratory and risk-assessment results rather than assuming a test order completes the process.
• Use risk tools only within their intended population and a locally supported workflow; do not apply a U.S. model as a Canadian mandate.
• Document medication-related concerns and communicate actionable findings through the patient’s agreed care pathway.
• Label staff education about this report as preliminary survey evidence and revisit it if a full study is published.

The question to carry back to practice is an operational one: can the team trace an abnormal finding to an accountable follow-up decision? This survey raises that question, but it cannot by itself answer how well Canadian clinics or pharmacies are doing.