title: Achieving blood pressure control among renal transplant recipients by integrating electronic health technology and clinical pharmacy services.
abstract: OBJECTIVE
  The implementation and outcomes of a program combining electronic home blood pressure monitoring (HBPM) and pharmacist-provided medication therapy management (MTM) services in a renal transplantation clinic are described.
  
  
  CONCLUSIONS
  Patients enrolled in the program were provided with a computer-enabled blood pressure monitor. A dedicated renal transplantation pharmacist was integrated into the renal transplantation team under a collaborative care practice agreement. The collaborative care agreement allowed the pharmacist to authorize medication additions, deletions, and dosage changes. Comprehensive disease and blood pressure education was provided by a clinical pharmacist. In the pretransplantation setting, the pharmacist interviewed the renal transplant candidate and documents allergies, verified the patient's medication profile, and identified and assessed barriers to medication adherence. A total of 50 renal transplant recipients with at least one recorded home blood pressure reading and at least one year of follow-up were included in our analysis. A significant reduction in mean systolic and diastolic blood pressure values were observed at 30, 90, 180, and 360 days after enrollment in the program (p < 0.05). Pharmacist interventions were documented for 37 patients. Medication-related problems accounted for 46% of these interventions and included dosage modifications, regimen changes, and mitigation of barriers to medication access and adherence.
  
  
  CONCLUSIONS
  Implementation of electronic HBPM and pharmacist-provided MTM services implemented in a renal transplant clinic was associated with sustained improvements in blood pressure control. Incorporation of a pharmacist in the renal transplant clinic resulted in the detection and resolution of medication-related problems.
authors.affiliation: Daniel R. Migliozzi, Pharm.D., BCPS, is Clinical Pharmacy Specialist, Renal Transplant, Department of Pharmacy, Rhode Island Hospital, Providence. Andrew R. Zullo, Pharm.D., is a doctoral student, Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, and Staff Pharmacist, Department of Pharmacy, Rhode Island Hospital. Christine Collins, B.S.Pharm., M.B.A., is Director, Department of Pharmacy, Rhode Island Hospital. Khaled A. Elsaid, Pharm.D., Ph.D., is Associate Professor, Department of Pharmaceutical Sciences, MCPHS University, Boston, MA.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Migliozzi
authors.affiliation: Daniel R. Migliozzi, Pharm.D., BCPS, is Clinical Pharmacy Specialist, Renal Transplant, Department of Pharmacy, Rhode Island Hospital, Providence. Andrew R. Zullo, Pharm.D., is a doctoral student, Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, and Staff Pharmacist, Department of Pharmacy, Rhode Island Hospital. Christine Collins, B.S.Pharm., M.B.A., is Director, Department of Pharmacy, Rhode Island Hospital. Khaled A. Elsaid, Pharm.D., Ph.D., is Associate Professor, Department of Pharmaceutical Sciences, MCPHS University, Boston, MA.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Zullo
authors.affiliation: Daniel R. Migliozzi, Pharm.D., BCPS, is Clinical Pharmacy Specialist, Renal Transplant, Department of Pharmacy, Rhode Island Hospital, Providence. Andrew R. Zullo, Pharm.D., is a doctoral student, Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, and Staff Pharmacist, Department of Pharmacy, Rhode Island Hospital. Christine Collins, B.S.Pharm., M.B.A., is Director, Department of Pharmacy, Rhode Island Hospital. Khaled A. Elsaid, Pharm.D., Ph.D., is Associate Professor, Department of Pharmaceutical Sciences, MCPHS University, Boston, MA.
authors.forename: Christine
authors.initials: C
authors.lastname: Collins
authors.affiliation: Daniel R. Migliozzi, Pharm.D., BCPS, is Clinical Pharmacy Specialist, Renal Transplant, Department of Pharmacy, Rhode Island Hospital, Providence. Andrew R. Zullo, Pharm.D., is a doctoral student, Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, and Staff Pharmacist, Department of Pharmacy, Rhode Island Hospital. Christine Collins, B.S.Pharm., M.B.A., is Director, Department of Pharmacy, Rhode Island Hospital. Khaled A. Elsaid, Pharm.D., Ph.D., is Associate Professor, Department of Pharmaceutical Sciences, MCPHS University, Boston, MA. khaled.elsaid@mcphs.edu.
authors.forename: Khaled A
authors.initials: KA
authors.lastname: Elsaid
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D020811:Biomedical Technology / Q000379:methods; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D003299:Cooperative Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D055118:Medication Adherence; D054539:Medication Therapy Management / Q000458:organization & administration; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration; D010353:Patient Education as Topic; D010595:Pharmacists / Q000458:organization & administration*; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D024382:Professional Role; D016730:Program Development; D015397:Program Evaluation; D055815:Young Adult