Division of Transplant Surgery, College of Medicine, Medical University of South Carolina, and Department of Pharmacy Services, Ralph H. Johnson VAMC, Charleston, SC.
Transplant Center, Medical University of South Carolina, and College of Pharmacy, Medical University of South Carolina, Charleston, SC.
Am J Health Syst Pharm. 2019 Jul 18;76(15):1143-1149. doi: 10.1093/ajhp/zxz115.
The development, testing, and preliminary validation of a technology-enabled, pharmacist-led intervention aimed at improving medication safety and outcomes in kidney transplant recipients are described.
Medication safety issues, encompassing medication errors (MEs), medication nonadherence, and adverse drug events (ADEs), are a predominant cause of poor outcomes after kidney transplantation. However, a limited number of clinical trials assessing the effectiveness of technology in improving medication safety and outcomes in transplant recipients have been conducted. Through an iterative, evidence-based approach, a technology-enabled intervention aimed at improving posttransplant medication safety outcomes was developed, tested, and preliminarily validated. Early acceptability and feasibility results from a prospective, randomized controlled trial assessing the effectiveness of this system are reported here. Of the 120 patients enrolled into the trial at the time of writing, 60 were randomly assigned to receive the intervention. At a mean ± S.D. follow-up of 5.8 ± 4.0 months, there were 2 patient dropouts in the intervention group, resulting in a retention rate of 98%, which was higher than the expected 90% retention rate.
The development and deployment of a comprehensive medication safety monitoring dashboard for kidney transplant recipients is feasible and acceptable to patients in the current healthcare environment. An ongoing randomized controlled clinical trial is assessing whether such a system reduces MEs and ADRs, leading to improved patient outcomes.
描述一种基于技术、由药剂师主导的干预措施的开发、测试和初步验证，该措施旨在改善肾移植受者的药物安全和结果。
药物安全问题，包括药物错误（MEs）、药物不依从和药物不良事件（ADEs），是肾移植后不良结果的主要原因。然而，评估技术在改善移植受者药物安全和结果方面的有效性的临床试验数量有限。通过迭代、基于证据的方法，开发、测试和初步验证了一种旨在改善移植后药物安全结果的基于技术的干预措施。这里报告了一项前瞻性、随机对照试验评估该系统有效性的早期可接受性和可行性结果。在撰写本文时，共有 120 名患者参加了试验，其中 60 名患者被随机分配接受干预。在平均±SD 随访 5.8±4.0 个月后，干预组有 2 名患者退出，保留率为 98%，高于预期的 90%保留率。
在当前的医疗保健环境下，为肾移植受者开发和部署全面的药物安全监测仪表板是可行且可接受的。正在进行的随机对照临床试验正在评估这样的系统是否可以减少 MEs 和 ADRs，从而改善患者的结果。
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