Changing transplant recipient education and inpatient transplant pharmacy practices: A single-center perspective

Maldonado, Angela Q.; Weeks, Douglas L.; Bitterman, Amanda; McCleary, Jo Ann; Seiger, Todd C.; Carson, Richard W.; Tabon, Patrick K.; Goroski, Angela L.; Ojogho, Okechukwu

doi:10.2146/ajhp120254

Cited by 24 publications

(10 citation statements)

References 11 publications

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“…In the multivariate analysis, only the presence of discrepancies in drug regimen with the community pharmacy was still significantly associated with a greater risk of CV of ≥30%. This observation suggests the key role of the clinical pharmacist in the healthcare management of recipients as has been previously demonstrated . Reconciliation, therapeutic programmes and pharmaceutical consultation offer an informative diagnosis of patient misunderstandings regarding their disease, medication and behaviours.…”

Section: Discussionsupporting

confidence: 60%

Factors associated with the variability of calcineurin inhibitor blood levels in kidney recipients grafted for more than 1 year

Belaiche¹,

Décaudin²,

Dharancy

et al. 2017

Fundamemntal Clinical Pharma

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A B S T R A C TThe study of calcineurin inhibitor (CNI) blood level variability to evaluate adherence in transplantation has improved over the years. The aim of our study was to assess factors associated with this variability using the coefficient of variation (CV). A cross-sectional sample of kidney recipients grafted for more than 1 year was recruited. We recorded clinical data, data from a clinical pharmacist interview and from six questionnaires measuring adherence, satisfaction, behaviours, beliefs, perception of the illness and social vulnerability. A total of 408 recipients were enrolled (61.2% male, mean age 54) and divided into two groups: low variability CV < 30% (n = 302), high variability CV ≥ 30% (n = 106). In univariate analysis, hospital-home distance, cyclosporine, time since transplantation and presence of discrepancies in drug regimen were associated with a greater risk of CV ≥ 30%. In contrast, tacrolimus QD conferred a lower risk of CV ≥ 30%. In multivariate analysis, only the presence of discrepancies remained significant: .01]; P = 0.022). Discrepancies in drug regimen appear as the main risk factor associated with CNI blood variability. The clinical pharmacist's input is an accurate and simple way of detecting non-adherence which is not revealed in self-report questionnaires.

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Section: Discussionsupporting

confidence: 60%

Factors associated with the variability of calcineurin inhibitor blood levels in kidney recipients grafted for more than 1 year

Belaiche¹,

Décaudin²,

Dharancy

et al. 2017

Fundamemntal Clinical Pharma

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“…Although the use of clinical pharmacists to improve medication safety and outcomes is well documented, there are limited studies analyzing the effectiveness of such interventions within the transplant population, and none specifically within veteran organ transplant recipients. The limited studies that demonstrate improved medication outcomes using pharmacists’ led interventions among transplant patients (a number of which are from our research group) predominantly focus on the acute perioperative hospitalization phase [25,26,41-44]. The innovative component of this proposal is the use of a pharmacist-led intervention during the longitudinal ambulatory phase, following the posttransplant surgical event.…”

Section: Discussionmentioning

confidence: 99%

Improving Transplant Medication Safety Through a Technology and Pharmacist Intervention (ISTEP): Protocol for a Cluster Randomized Controlled Trial

Hall¹,

Fominaya²,

Gebregziabher³

et al. 2019

JMIR Res Protoc

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Background Medication errors, adverse drug events, and nonadherence lead to increased health care utilization and increased risk of adverse clinical outcomes, including graft loss, in solid organ transplant recipients. Veterans living with organ transplants represent a population that is at substantial risk for medication safety events and fragmented care coordination issues. To improve medication safety and long-term clinical outcomes in veteran transplant patients, interventions should address interorganizational system failures and provider-level and patient-level factors. Objective This study aims to measure the clinical and economic effectiveness of a pharmacist-led, technology-enabled intervention, compared with usual care, in veteran organ transplant recipients. Methods This is a 24-month prospective, parallel-arm, cluster-randomized, controlled multicenter study. The pharmacist-led intervention uses an innovative dashboard system to improve medication safety and health outcomes, compared with usual posttransplant care. Pharmacists at 10 study sites will be consented into this study before undergoing randomization, and 5 sites will then be randomized to each study arm. Approximately, 1600 veteran transplant patients will be included in the assessment of the primary outcome across the 10 sites. Results This study is ongoing. Institutional review board approval was received in October 2018 and the study opened in March 2019. To date there are no findings from this study, as the delivery of the intervention is scheduled to occur over a 24-month period. The first results are expected to be submitted for publication in August 2021. Conclusions With this report, we describe the study design, methods, and outcome measures that will be used in this ongoing clinical trial. Successful completion of the Improving Transplant Medication Safety through a Technology and Pharmacist Intervention study will provide empirical evidence of the effectiveness of a feasible and scalable technology-enabled intervention on improving medication safety and costs. Clinical Trial ClinicalTrials.gov NCT03860818; https://clinicaltrials.gov/ct2/show/NCT03860818 International Registered Report Identifier (IRRID) PRR1-10.2196/13821

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“…znacząco wpłynęło na długość hospitalizacji pacjentów. Zmniejszyła się ona średnio z 7,8 do 3,4 dni, co pozwoliło zaoszczędzić 279 180 USD rocznie [18].…”

Section: Korzyści Ekonomiczneunclassified

Conciliation – a new element of pharmacovigilance

Jaźwińska−Tarnawska¹,

Ungeheuer²,

Tusińska³

et al. 2018

Farm Pol.

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Changing transplant recipient education and inpatient transplant pharmacy practices: A single-center perspective

Abstract: The participation of pharmacists on the kidney transplant team enhanced a hospital's medication management, discharge planning, and patient education services for transplant recipients, helping to reduce their average LOS and yielding substantial cost savings.

Cited by 24 publications

References 11 publications

Factors associated with the variability of calcineurin inhibitor blood levels in kidney recipients grafted for more than 1 year

Factors associated with the variability of calcineurin inhibitor blood levels in kidney recipients grafted for more than 1 year

Improving Transplant Medication Safety Through a Technology and Pharmacist Intervention (ISTEP): Protocol for a Cluster Randomized Controlled Trial

Conciliation – a new element of pharmacovigilance

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