*Purpose: This study describes the development of a Collaborative Pharmacy Practice Agreement (CPPA) between transplant pharmacists and physicians and assesses change in prescription volume and workload before and after CPPA implementation.

*Methods: After Tennessee Pharmacist Association and Tennessee Medical Association finalized legislation approving CPPAs for licensed pharmacists in Tennessee (effective July 1, 2014), Vanderbilt Renal Transplant Clinic and Vanderbilt Transplant Pharmacy began developing a CPPA, which was approved by Vanderbilt University Medical Center (VUMC) Pharmaceutical and Therapeutics Committee and VUMC Medical Board. Subsequently, VUMC legal department amended Tennessee state law to further define CPPAs and auditing requirements, which was approved by the Tennessee Board of Pharmacy and the Tennessee State Attorney General. Once the CPPA was in place, we assessed the authorizer for immunosuppressant prescriptions (nurse, physician, or pharmacist; measured as % of immunosuppressant prescriptions) and the volume of immunosuppressant prescriptions across three 7-month intervals: Time 1) before pharmacist clinic integration; Time 2) after pharmacist integration but prior to a CPPA; and Time 3) after pharmacist integration and establishment of a CPPA. We also assessed the total volume of prescriptions filled by the Transplant Pharmacy during this period. Study participants included adult patients with at least one immunosuppressant prescription generated in each time interval. Frequency of safety concerns were collected from safety monitoring data in seven quarterly reviews.

*Results: From Time 1 to Time 3, total prescriptions filled by the Transplant Pharmacy increased from 13,523 to 45,320 (Figure 1), and physician and nurse refill workload reduced from 42.7% and 57.3% to 8.7% and 5.9% for prescription generation. No safety concerns were reported in any quarterly review.

*Conclusions: After implementing a CPPA, prescription generation volume increased and physician and nurse burden decreased. This streamlined process from prescribing to dispensing prescriptions ensures close monitoring of post-transplant patients, while allowing physicians and nurses to dedicate more time to focus on patient care.

« Back to 2019 American Transplant Congress