title: Influence of pill burden and drug cost on renal function after transplantation.
abstract: OBJECTIVE
  To determine the influence of pill burden and drug cost on outcomes after renal transplantation.
  
  
  METHODS
  Retrospective medical record review.
  
  
  METHODS
  Kidney and pancreas transplantation center.
  
  
  METHODS
  Sixty-eight adults who underwent kidney or kidney-pancreas transplantation during 2007.
  
  
  RESULTS
  The median pretransplantation pill burden was 15 pills/day, which increased to 25 pills/day at 1 month after transplantation and returned to 16 pills/day by 1 year after transplantation. Pretransplantation pill burden was lower than the burden at 1, 3, 6, 12, and 24 months after transplantation (p<0.05). The mean pretransplantation drug cost of $1918/month was lower than the cost at 1 month after transplantation ($2564/mo, p=0.04) but was similar thereafter. Higher pretransplantation pill burden was associated with increased serum creatinine concentration at 6 months after transplantation (r=0.288, p=0.017). Higher pill burdens at 1 month (r=0.364, p=0.002), 3 months (r=0.332, p=0.006), and 6 months (r=0.374, p=0.002) were associated with increased 3-month serum creatinine concentration. Higher drug costs were associated with increased serum creatinine concentrations throughout the study.
  
  
  CONCLUSIONS
  Higher pretransplantation pill burden and higher drug cost may be associated with poor renal function after transplantation. Further study addressing factors associated with nonadherence is needed.
authors.affiliation: Division of Pharmacy Practice and Administration, School of Pharmacy, University of Missouri-Kansas City, Kansas City, Missouri 64108-2792, USA. hardingerk@umkc.edu
authors.forename: Karen L
authors.initials: KL
authors.lastname: Hardinger
authors.forename: Timothy
authors.initials: T
authors.lastname: Hutcherson
authors.forename: David
authors.initials: D
authors.lastname: Preston
authors.forename: Daniel
authors.initials: D
authors.lastname: Murillo
mesh_terms: D016208:Databases, Factual; D016527:Drug Costs; D057286:Electronic Health Records; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008875:Middle Aged; D016035:Pancreas Transplantation; D055553:Prescription Drugs / Q000008:administration & dosage / Q000191:economics; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D016903:Drug Monitoring
chemical_list: D055553:Prescription Drugs