Impact of clinical pharmacy services on renal transplant recipients' adherence and outcomes

Abstract

The purpose of this article is to provide a description of a clinical pharmacy services program implemented in a renal transplant clinic to improve medication access and adherence as well as health and economic outcomes among renal transplant recipients (RTRs). Following a team-based planning process and an informal survey of RTRs, a clinical pharmacy service intervention was implemented in the Medical College of Georgia renal transplant clinic. As part of the intervention, a clinical pharmacist reviewed and optimized medication therapy, provided instructions on how to take medication, and assisted with enrollment into medication assistance programs. Significant differences were found between RTRs who did and did not receive clinical pharmacy services on measures of adherence, health, economics, and quality of life. Clinical pharmacy services, as described in this article, have a positive impact on renal transplant recipients' medication adherence, health and economic outcomes, and health-related quality of life. The findings described here suggest that clinical pharmacy services are a viable and effective option for improving care for RTRs in an outpatient clinic setting.

Keywords: economic outcomes; health outcomes; immunosuppressant therapy adherence; renal transplant recipients.

Figure 1

Fishbone diagram of possible causes of nonadherence. Abbreviations: IST, immunosuppressant therapy; RTR, renal transplant recipient.

Figure 2

Pareto chart of problems addressed by clinical pharmacist’s recommendations (Chisholm et al 2000c).