*Purpose: A collaborative pharmacy practice agreement (CPPA) permits pharmacists to perform clinical services under the guidance of a supervising physician without direct physician intervention. We aimed to quantify and categorize interventions performed by two clinical pharmacists with a CPPA at an academic renal transplant clinic and determine the impact of interventions on patient care.

*Methods: Clinic notes were reviewed to collect pharmacist interventions (defined as an encounter with one or more actions to improve patient outcomes), performed between 1/01/2019-06/30/2019, for adult patients prescribed immunosuppressant or non-immunosuppressant medication. Interventions were categorized by type (medical record assessments, medication counseling, or resolution of barriers to medication continuation), then further classified into subcategories. The number and type of interventions performed were summarized with frequency distributions. We also calculated the number of prescription orders entered by the clinical pharmacists during this time.

*Results: During the 6-month window, clinical pharmacists under a CPPA placed 2,997 prescription orders and performed 1,821 clinical chart reviews for 958 patients. Five percent of all orders were audited by the attending physician with a zero percent error rate. Within all clinical chart reviews, 3,852 interventions were performed: 2,695 medical record assessments, 734 medication counseling, and 423 resolutions of barriers to medication continuation.

*Conclusions: Pharmacists practicing under a CPPA were able to reduce provider burden by managing the prescribing of transplant medications. The most common intervention performed was medical record assessment, which facilitates prescribing of appropriate medication and dosage. Pharmacist interventions ensured treatment adherence and persistence in patients that were evaluated.

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