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MARIE A. CHISHOLM, PHARM.D., FCCP, FASHP, is Professor and Department Head, Pharmacy Practice and Science, The University of Arizona College of Pharmacy (UACP); CHRISTINA A. SPIVEY, PH.D., is Research Coordinator, Pharmacy Practice and Science, UACP; and LAURA L. MULLOY, D.O., FACP, is Professor of Medicine and Chief, Section of Nephrology, Hypertension and Transplantation Medicine, Medical College of Georgia School of Medicine, Augusta, GA.

Address correspondence to Dr. Chisholm at the University of Arizona College of Pharmacy, Medical College of Georgia School of Medicine, 1295 North Martin Avenue, Pharmacy–Pulido Center, Tucson, AZ 85750 (chisholm{at}pharmacy.arizona.edu).

Purpose. 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 preenrollment and one year postenrollment), 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 (HbA1c), blood pressure, low-density-lipoprotein (LDL) cholesterol, total cholesterol, triglycerides, and serum immunosuppressant concentrations were identified for one year preenrollment and one year postenrollment. HQOL was measured at the time of enrollment and one year postenrollment. 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 postenrollment versus preenrollment (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 preenrollment levels (p < 0.01). A significantly greater number of patients reached target serum cyclosporine levels postenrollment versus preenrollment (p = 0.008). HQOL was significantly increased one year postenrollment (p < 0.01). Conclusion. A medication assistance program that included MTM services improved medication access, clinical outcomes, and HQOL in renal transplant recipients. Index terms: Antidiabetic agents; Antilipemic agents; Blood levels; Charity; Clinical pharmacy; Cyclosporine; Diabetes mellitus; Drug distribution; Drug use; Graft rejection; Hyperlipidemia; Hypertension; Hypotensive agents; Immunosuppressive agents; Outcomes; Pharmaceutical services; Prescriptions; Quality of life; Rational therapy; Transplantation

 

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