Changing transplant recipient education and inpatient transplant pharmacy practices: A single-center perspective

Abstract

Pharmacists' contributions to improved inpatient medication practices and educational services for kidney transplant recipients at a community hospital were evaluated. A retrospective observational analysis was conducted using demographic and case data collected during the year before (2007) and three years after (2011) the inclusion of pharmacists on the hospital's interdisciplinary kidney transplant team. Qualitative variables assessed included changes in prescribing practices, inpatient and outpatient transplant personnel, discharge planning processes, medication reconciliation, educational practices, and transplant program workflow; quantitative variables included average hospital length of stay (LOS), Scientific Registry of Transplant Recipients data, readmission rates, and reimbursement data. A comparison of data on kidney transplant procedures performed at the hospital in 2007 (n = 60) and 2011 (n = 54) indicated that the implementation of specialized transplant pharmacy services was particularly beneficial in the areas of inpatient medication management, medication reconciliation, discharge planning, and patient education. Program outcomes related to the inclusion of pharmacists on the kidney transplant team included a decrease in the mean LOS among transplant recipients (from 7.8 days in 2007 to 3.4 days in 2011, p < 0.001), with no adverse effect on all-cause 30-, 90-, and >90-day readmission rates (all p > 0.09). Annual cost savings attributable to the reduction in LOS were estimated at $279,180. The participation of pharmacists on the kidney transplant team enhanced a hospital's medication management, discharge planning, and patient education services for transplant recipients, helping to reduce their average LOS and yielding substantial cost savings.