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Can J Hosp Pharm. 2018 Sep-Oct;71(5):324-337. Epub 2018 Oct 31.

Roles and Impacts of the Transplant Pharmacist: A Systematic Review.

Author information

1
, PharmD, is with the Pharmacy Practice Research Unit, Pharmacy Department, Centre hospitalier universitaire Sainte-Justine, Montréal, Quebec.
2
, PharmD, PhD, is with the Pharmacy Department, Hôpital Antoine-Bédère, Clamart, France.
3
, PharmD, is with the Pharmacy Department, Centre hospitalier universitaire Lille, Lille, France.
4
, BPharm, MSc, MBA, FCSHP, is with the Pharmacy Practice Research Unit, Pharmacy Department, Centre hospitalier universitaire Sainte-Justine, and the Faculty of Pharmacy, Université de Montréal, Montréal, Quebec.

Abstract

in English, French

Background:

Pharmacists have been involved in the care of transplant recipients for several decades, and a growing body of literature shows the beneficial effects of clinical pharmacist care on important outcomes for these patients.

Objectives:

The primary objective was to describe the roles and impacts of pharmacists in a solid organ transplant setting. The secondary objective was to describe and rate the pharmacists' interventions.

Data Sources:

Three databases-PubMed, Embase, and Evidence-Based Medicine Reviews-were searched from January 1, 1990, to June 16, 2015.

Study Selection and Data Extraction:

All studies addressing the roles of pharmacists and the impacts of clinical pharmacy services on the care of solid organ transplant recipients were considered. Only studies providing a statistical analysis were included. Design, setting, sample size, patient characteristics, pharmacists' interventions, study bias, and outcomes were extracted for analysis.

Data Synthesis:

Four randomized controlled trials, 4 cohort studies, 3 pre-post studies, and 1 quasi-randomized controlled trial were included in the review, representing a total of 1837 patients. Of the 12 studies included, 8 specifically focused on renal transplant, and 1 each focused on liver, lung, abdominal organ, and general solid organ transplant. The pivotal pharmacist activities leading to the main patient outcomes were medication counselling (n = 8 studies), medication reconciliation (n = 5), and reviewing and optimizing drug therapy (n = 3). Improvements to medication adherence (n = 6 studies), morbidity (n = 4), costs (n = 2), and medication errors (n = 2) were reported.

Conclusion:

Currently available evidence suggests that pharmacists can improve patient outcomes in the solid organ transplant setting. Adherence, morbidity, costs, and medication errors were identified as the main outcomes that were improved by pharmaceutical interventions. Transplant programs need to invest more in this resource.

KEYWORDS:

clinical pharmacy; impact; organ transplantation; outcome-based research; pharmacist

PMID:
30401999
PMCID:
PMC6209508
[Available on 2019-03-01]

Conflict of interest statement

Competing interests: None declared.

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