Session Date & Time: None. Available on demand.
*Purpose: The United Network for Organ Sharing (UNOS) and Centers for Medicare and Medicaid Services (CMS) requires transplant centers to document the participation of a clinical pharmacist on multidisciplinary solid organ transplant (SOT) teams. These pharmacists are integral in providing and supporting evidence-based practices, quality improvement initiatives, medication access, patient education and protocol development. The purpose of this study is to evaluate the impact of SOT pharmacists on the care of SOT recipients.
*Methods: This prospective, quality improvement, chart review included all patients who received a SOT and had at least one clinical intervention documented by the transplant pharmacist (3 full-time pharmacists and 1 SOT resident). The primary objective of the study was to determine the impact of the transplant pharmacy team in identifying and correcting medication errors pertaining to immunosuppression, rejection, and infection (antiviral, antifungal and PJP prophylaxis and treatment). The secondary objectives were to quantify the acceptance rate of the interventions, estimate financial impact of the interventions made, and quantify the time commitment to optimize medication regimens.
*Results: A total of 210 patients were included in the study from July 1 to November 9, 2020. Transplant pharmacists documented 1,380 interventions in the three-month period with an acceptance rate of 95%. The most common type of transplant with documented interventions was lung (59%) followed by kidney (16.2%), heart (11.9%), liver (8.1%), heart-kidney (1.9%), kidney-pancreas (1.4%), heart-lung (1%) and liver-kidney (0.5%).The most common intervention categories were dosing issues (69.9%) followed by appropriate therapy (20.1%). A breakdown of types of interventions within these categories is located in the table below. The median number of interventions per patient was four [IQR: 1-9]. The total time spent making clinical interventions was 8,139 minutes. Through the clinical interventions recommended by transplant pharmacists, the estimated cost-avoidance was $319,787.
|Intervention type||Immunosuppression||Infection and rejection|
|Kinetic dose adjustment||539||0|
|Renal dose adjustment||1||115|
|Dosing adjustment (other)||119||32|
|Additional drug required||113||107|
|IV to PO||44||47|
*Conclusions: Transplant pharmacists play an integral role in SOT multidisciplinary teams to optimize patient care through identification and correction of medication errors related to immunosuppression, infection, and rejection. Interpretation of these results may be limited by inter-pharmacist variability in documentation. Appropriate identification and correction of medication errors is associated with significant cost-avoidance.
To cite this abstract in AMA style:Shah I, Au J, Diamond A, Sifontis N, Ruggia-Check C. Clinical Impact of Transplant Pharmacists on the Care of Solid Organ Transplant Recipients [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/clinical-impact-of-transplant-pharmacists-on-the-care-of-solid-organ-transplant-recipients/. Accessed June 13, 2021.
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