Chisholm Marie A, Spivey Christina A, Mulloy Laura L
Pharmacy Practice and Science, The University of Arizona College of Pharmacy, Tucson, AZ 85750, USA.
Am J Health Syst Pharm. 2007 Jul 15;64(14):1506-12. doi: 10.2146/ajhp060634.
The effects of a medication assistance program with medication therapy management (MTM) on the clinical outcomes and health-related quality of life (HQOL) of renal transplant recipients were studied.
All renal transplant recipients who were enrolled in the Medication Access Program at the Medical College of Georgia for at least one year were included in the study. Patients' demographics, number of graft rejections (for one year pre-enrollment and one year post-enrollment), and diagnoses of hypertension, diabetes, and dyslipidemia were recorded and confirmed by medical and pharmacy records. The use of antihypertensive, antidiabetic, antilipemic, and immunosuppressant agents and laboratory values for fasting blood glucose, glycosylated hemoglobin (HbA(1c)), blood pressure, low-density-lipoprotein (LDL) cholesterol, total cholesterol, triglycerides, and serum immunosuppressant concentrations were identified for one year pre-enrollment and one year post-enrollment. HQOL was measured at the time of enrollment and one year post-enrollment.
Thirty-six adult renal transplant recipients were included in the study. All patients had hypertension, 72% had dyslipidemia, and 42% had diabetes. Patients received significantly more antihypertensive agents post-enrollment versus pre-enrollment (p < 0.001) and significantly more antidiabetic agents (p = 0.004) and antilipemics (p = 0.001). Measures of fasting blood glucose, glycosylated hemoglobin, LDL cholesterol, total cholesterol, triglycerides, blood pressure, and number of graft rejections decreased from pre-enrollment levels (p < 0.01). A significantly greater number of patients reached target serum cyclosporine levels post-enrollment versus pre-enrollment (p = 0.008). HQOL was significantly increased one year post-enrollment (p < 0.01).
A medication assistance program that included MTM services improved medication access, clinical outcomes, and HQOL in renal transplant recipients.
研究一项包含药物治疗管理（MTM）的药物援助项目对肾移植受者临床结局及健康相关生活质量（HQOL）的影响。
纳入所有在佐治亚医学院药物获取项目中登记至少一年的肾移植受者。记录患者的人口统计学数据、移植排斥次数（登记前一年和登记后一年）以及高血压、糖尿病和血脂异常的诊断情况，并通过医疗和药房记录进行确认。确定登记前一年和登记后一年使用的抗高血压药、抗糖尿病药、抗血脂药和免疫抑制剂以及空腹血糖、糖化血红蛋白（HbA(1c)）、血压、低密度脂蛋白（LDL）胆固醇、总胆固醇、甘油三酯和血清免疫抑制剂浓度的实验室值。在登记时和登记后一年测量HQOL。
36名成年肾移植受者纳入研究。所有患者均患有高血压，72%患有血脂异常，42%患有糖尿病。与登记前相比，患者登记后使用的抗高血压药显著增多（p < 0.001），抗糖尿病药（p = 0.004）和抗血脂药（p = 0.001）也显著增多。空腹血糖、糖化血红蛋白、LDL胆固醇、总胆固醇、甘油三酯、血压和移植排斥次数的测量值从登记前水平下降（p < 0.01）。与登记前相比，登记后达到目标血清环孢素水平的患者数量显著增加（p = 0.008）。登记后一年HQOL显著提高（p < 0.01）。
一项包含MTM服务的药物援助项目改善了肾移植受者的药物获取、临床结局和HQOL。
