Effects of a medication assistance program with medication therapy management on the health of renal transplant recipients.
OBJECTIVE
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
A medication assistance program that included MTM services improved medication access, clinical outcomes, and HQOL in renal transplant recipients.
Chisholm
Marie A
MA
Pharmacy Practice and Science, The University of Arizona College of Pharmacy, Tucson, AZ 85750, USA. chisholm@pharmacy.arizona.edu
Spivey
Christina A
CA
Mulloy
Laura L
LL
D000328:Adult; D000368:Aged; D005260:Female; D005845:Georgia; D006084:Graft Rejection / Q000188:drug therapy / Q000453:epidemiology; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics / Q000627:therapeutic use; D007356:Insurance, Pharmaceutical Services / Q000191:economics*; D016030:Kidney Transplantation / Q000191:economics*; D008297:Male; D008875:Middle Aged; D010346:Patient Care Management / Q000191:economics* / Q000379:methods; D011788:Quality of Life / Q000523:psychology
D007166:Immunosuppressive Agents