Session Name: Non-Organ Specific: Pharmacogenomics / Pharmacokinetics
Session Date & Time: None. Available on demand.
*Purpose: Pharmacist involvement in the outpatient transplant clinic setting has been correlated with improved patient outcomes in single organ cohort studies. Direct clinical pharmacist involvement began in the outpatient transplant clinic at our institution in early 2018. Our study aim was to evaluate the impact of transplant clinical pharmacists’ interventions within a multi-organ post-transplant clinic.
*Methods: Patients discharged from their transplant admission between August 1, 2016 and August 1, 2019 were reviewed. Patients were placed in one of two cohorts based on the presence or absence of a transplant pharmacist outpatient note within 30 days of transplant discharge in addition to receiving standard provider follow up. Patients in each cohort were matched 1:1 by organ type. The primary outcome of this study was to determine the probability of any all-cause hospital encounter 90 days post-transplant discharge. Secondary endpoints included hospital admission encounters, emergency department encounters, biopsy confirmed organ rejection, blood pressure, blood glucose, protocol-driven prophylactic medication renal dosing, and all-cause mortality.
*Results: During the study period, a total of 600 patients were evaluated with 300 included in each cohort. The study population included higher risk patients: 508 (84.7%) pretransplant hypertension, 272 (45.3%) pretransplant diabetes mellitus, average age 51.9 ± 11.8 years. One hundred and forty-six patients (48.7%) in the pharmacist cohort experienced a hospital encounter in comparison to 154 patients (51.3%) in the control group (p=0.513). Appropriate renal dosing of prophylactic medications was significantly higher in the pharmacist cohort at 30, 60 and 90 days (p=0.032, p=0.009, p=0.002). Selected additional secondary outcomes are listed in table 1.
*Conclusions: All-cause hospital encounters 90 days post-transplant did not differ between groups. Clinical pharmacist involvement in the outpatient transplant setting is associated with a significantly higher rate of appropriate renal dosing of standard prophylactic medications. Additional analysis of hospital encounters is warranted to further elucidate differences between groups. Prospective cohort studies of transplant clinical pharmacist interventions are needed.
|Pharmacist (n=300)||Control (n=300)||p-value|
|Hospital admission||40.3% (n=121)||44% (n=132)||p=0.363|
|Emergency department visit not resulting in admission||15.7% (n=47)||15.3% (n=46)||p=0.91|
|Biopsy confirmed rejection||14% (n=42)||15.7% (n=47)||p=0.566|
|Death||0.3% (n=1)||0.7% (n=2)||p=1|
To cite this abstract in AMA style:Roe O, Gattis S, Parsons R, Lo D, Todd S. Impact of the Transplant Clinical Pharmacist in an Outpatient Transplant Clinic [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-the-transplant-clinical-pharmacist-in-an-outpatient-transplant-clinic/. Accessed June 12, 2021.
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