The clinical pharmacist interventions among solid organ transplant recipients admitted to ICU
Aysel Pehlivanli1,2, Fatma Irem Yesiler3, Tugba Yanik Yalcin4, Helin Sahinturk3, Bilgen Basgut1,2, Pinar Zeyneloglu3, Mehmet A. Haberal5.
1Faculty of Pharmacy, Baskent University, Ankara, Turkey; 2Clinical Pharmacy and Drug Information Center, Baskent University, Ankara, Turkey; 3Department of Anaesthiology and Reanimation, Baskent University, Ankara, Turkey; 4Department of Infectious Diseases and Clinical Microbiology, Baskent University, Ankara, Turkey; 5Department of General Surgery, Division of Transplantation, Baskent University, Ankara, Turkey
Introduction: Solid organ transplant recipients (SOTr) require lifelong immunosuppression to prevent organ rejection. Especially the early postoperative period is the period when multiple drug use is highest (1). The United Network for Organ Sharing (UNOS) requires that all transplant programs identify at least one pharmacist to be responsible for providing pharmaceutical care to SOTr (2).
Purpose: This study aims to evaluate drug-related problems (DRPs) by a clinical pharmacy service with a multidisciplinary approach among SOTr admitted to intensive care unit (ICU) during the early and late postoperative period.
Materials and Methods: This retrospective descriptive study was conducted from December 7, 2022 to February 20, 2023 in the ICU of Başkent University Ankara Hospital. The DRPs were categorized according to the Pharmaceutical Care Network Europe (PCNE) V9.1 classification. The primary outcomes were the interventions proposed and the rate of acceptance by the transplant team.
Findings: Overall, 39 patients were included in determining DRPs during the treatment process of the patients. There were 27 liver (71.1%), 10 kidney (26.3%), and 2 heart (5.3%) transplant recipients. Fifteen DRPs were found in 13 (34.2%) patients. “Treatment safety” (53.3%) was the most common problem of DRPs. “Dose selection” (53.3%), and “Inappropriate combination of drugs, or drugs and herbal medications, or drugs and dietary supplements” (33.3%) were the most common causes, respectively. The most common medication class in DRPs was antimicrobial drugs (93.3%). The transplant team accepted 86.7% of the interventions.
Conclusion: This study shows that DRPs are common among SOTr. DRP prevalence and acceptance rates of clinical pharmacist recommendations are similar to the previous studies. Multidisciplinary approach involving clinical pharmacy services may improve the therapeutic outcomes of SOTr.
1.Yang H, Li L, Hu X, et al. Impact of pharmacist-led post-transplant medication management for kidney transplant recipients: A retrospective pre-and post-intervention study. J Clin Pharm Ther. 2019 Aug;44(4):603-610.
2.Wiegel JJ, Olyaei AJ. The role of the pharmacist in the management of kidney transplant recipients. Indian J Urol. 2016;32:192‐198.
