Interventions performed by clinical pharmacist in the renal transplant ambulatory care

Introduction: The development of new immuno-suppressant agents and other supporting medications has increased the complexity of medical regimes. Therefore, potential drug interactions, adverse reactions and costs may jeopardize a successful outcome. Although pharmacists have been involved in the ca...

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Autores principales:	Diego Gnatta, Elizete Keitel, Isabela Heineck
Formato:	article
Lenguaje:	EN PT
Publicado:	Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde 2020
Materias:	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/18f3e2eedc8e4d769733ec6a72f5d05d
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spelling	oai:doaj.org-article:18f3e2eedc8e4d769733ec6a72f5d05d2021-11-28T02:45:32ZInterventions performed by clinical pharmacist in the renal transplant ambulatory care10.30968/rbfhss.2019.103.03552179-59242316-7750https://doaj.org/article/18f3e2eedc8e4d769733ec6a72f5d05d2020-03-01T00:00:00Zhttps://www.rbfhss.org.br/sbrafh/article/view/355https://doaj.org/toc/2179-5924https://doaj.org/toc/2316-7750 Introduction: The development of new immuno-suppressant agents and other supporting medications has increased the complexity of medical regimes. Therefore, potential drug interactions, adverse reactions and costs may jeopardize a successful outcome. Although pharmacists have been involved in the care of patients after transplants, only a few kidney transplant teams can count with dedicated pharmaceutical services. Objective: The goal of this study was to describe the pharmaceutical interventions performed to improve treatment outcomes of patients who underwent kidney transplantation. Methods: This study was a randomized clinical trial and was carried out in a specialized transplant hospital in southern Brazil. The clinical pharmacist followed up 64 patients during a period of 12 months and performed interventions when identifying a drug related problem. The pharmaceutical interventions were categorized as “significant”, “very significant” or “extremely significant”. Medication-related negative outcomes were classified in relation to their effectiveness, safety and necessity. Results: Two hundred and twenty-six (226) pharmaceutical interventions were performed, with a mean of 3.25 ± 2.37 per patient. Among them, 159 (70.4%) were patient-oriented, and 67 (29.6%) were health teamoriented. Thirty eight percent were classified as very significant. Frequent pharmaceutical interventions performed were to suggest the reduction of immuno-suppressant doses to the physicians, educate patients with post-transplant diabetes mellitus or in case of skipping doses. One hundred and fourteen (114) medication-related negative outcomes were identified, 43% related to effectiveness, 36% to safety and 21% to necessity. The number of acute rejection confirmed by biopsy was 33 (51.6%). The free survival of acute rejection was 59.4% in the first month, 53.1% in the third month and 48.3% in 12 months. Conclusions: The pharmacist has an important role in the ambulatory care of kidney transplant, identifying problems and acting as a major player towards the reduction of medication-related negative outcomes. Diego GnattaElizete KeitelIsabela HeineckSociedade Brasileira de Farmácia Hospitalar e Serviços de SaúdearticlePublic aspects of medicineRA1-1270Pharmacy and materia medicaRS1-441Therapeutics. PharmacologyRM1-950ENPTRevista Brasileira de Farmácia Hospitalar e Serviços de Saúde, Vol 10, Iss 3 (2020)
institution	DOAJ
collection	DOAJ
language	EN PT
topic	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950
spellingShingle	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950 Diego Gnatta Elizete Keitel Isabela Heineck Interventions performed by clinical pharmacist in the renal transplant ambulatory care
description	Introduction: The development of new immuno-suppressant agents and other supporting medications has increased the complexity of medical regimes. Therefore, potential drug interactions, adverse reactions and costs may jeopardize a successful outcome. Although pharmacists have been involved in the care of patients after transplants, only a few kidney transplant teams can count with dedicated pharmaceutical services. Objective: The goal of this study was to describe the pharmaceutical interventions performed to improve treatment outcomes of patients who underwent kidney transplantation. Methods: This study was a randomized clinical trial and was carried out in a specialized transplant hospital in southern Brazil. The clinical pharmacist followed up 64 patients during a period of 12 months and performed interventions when identifying a drug related problem. The pharmaceutical interventions were categorized as “significant”, “very significant” or “extremely significant”. Medication-related negative outcomes were classified in relation to their effectiveness, safety and necessity. Results: Two hundred and twenty-six (226) pharmaceutical interventions were performed, with a mean of 3.25 ± 2.37 per patient. Among them, 159 (70.4%) were patient-oriented, and 67 (29.6%) were health teamoriented. Thirty eight percent were classified as very significant. Frequent pharmaceutical interventions performed were to suggest the reduction of immuno-suppressant doses to the physicians, educate patients with post-transplant diabetes mellitus or in case of skipping doses. One hundred and fourteen (114) medication-related negative outcomes were identified, 43% related to effectiveness, 36% to safety and 21% to necessity. The number of acute rejection confirmed by biopsy was 33 (51.6%). The free survival of acute rejection was 59.4% in the first month, 53.1% in the third month and 48.3% in 12 months. Conclusions: The pharmacist has an important role in the ambulatory care of kidney transplant, identifying problems and acting as a major player towards the reduction of medication-related negative outcomes.
format	article
author	Diego Gnatta Elizete Keitel Isabela Heineck
author_facet	Diego Gnatta Elizete Keitel Isabela Heineck
author_sort	Diego Gnatta
title	Interventions performed by clinical pharmacist in the renal transplant ambulatory care
title_short	Interventions performed by clinical pharmacist in the renal transplant ambulatory care
title_full	Interventions performed by clinical pharmacist in the renal transplant ambulatory care
title_fullStr	Interventions performed by clinical pharmacist in the renal transplant ambulatory care
title_full_unstemmed	Interventions performed by clinical pharmacist in the renal transplant ambulatory care
title_sort	interventions performed by clinical pharmacist in the renal transplant ambulatory care
publisher	Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde
publishDate	2020
url	https://doaj.org/article/18f3e2eedc8e4d769733ec6a72f5d05d
work_keys_str_mv	AT diegognatta interventionsperformedbyclinicalpharmacistintherenaltransplantambulatorycare AT elizetekeitel interventionsperformedbyclinicalpharmacistintherenaltransplantambulatorycare AT isabelaheineck interventionsperformedbyclinicalpharmacistintherenaltransplantambulatorycare
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Interventions performed by clinical pharmacist in the renal transplant ambulatory care

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