Purpose: Previously, kidney transplant pharmacy services at our institution were limited to medication profile review before and after transplant surgery. Following an OPTN accreditation site visit, transplant surgery partnered with pharmacy to increase pharmacist involvement. The purpose of this quality improvement report is to describe the collaboration between pharmacy and transplant surgery to provide comprehensive pharmacy services.

Methods: Beginning in July 2013, transplant surgery and pharmacy partnered to expand pharmacy services through the addition of an ambulatory care clinical pharmacist, training of inpatient pharmacists to provide a standard discharge pharmacy process, standardized generic tacrolimus product dispensing, and creation of a transplant specialty pharmacy management program (TSPMP). The aim of the project was to reach 100% provision of desired pharmacy services by July 2015. The desired pharmacy services included pre-transplant drug interactions review, adherence assessment, and medication education, and post-transplant discharge medication education and outpatient pharmacist follow-up. The average rate of provision of desired pharmacy services was assessed every 6 months. Process metrics included the rate of patients enrolled in the TSPMP, sum of outpatient prescription volume, and rate of generic immunosuppression prescriptions dispensed.

Results: From August 2012 to July 2015, we identified 106 new kidney transplant recipients who received pharmacy services, with a median of 18 transplants during each 6-month period. The average rate of comprehensive pharmacy services provided by pharmacists increased during each 6-month period from 27% in August 2012 to 93% in July 2015. Additionally, from 2012 to 2015, TSPMP enrollment increased from 21% to 100%, prescription volume increased from 753 to 1525 prescriptions filled, and the rate of generic tacrolimus prescribing increased from 25% to 97%.

Conclusion: The addition of an ambulatory care pharmacist and specialty pharmacy management program increased the provision of comprehensive transplant pharmacy services. This demonstrates the feasibility of quality improvements at small transplant institutions to better meet OPTN accreditation standards.

CITATION INFORMATION: Dickson J, Vincent III W, Wu L, Thurman J, Francis J, Nuhn M. Quality Improvement Initiative to Provide Comprehensive Pharmacy Services to Kidney Transplant Patients at a Small Transplant Center. Am J Transplant. 2016;16 (suppl 3).

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