장기이식 약사의 역할에 관한 연구: 장기이식 입원 환자를 위한 처방 중재
Studies on the Roles of Transplant Pharmacists: Prescription Intervention for Solid Organ Transplant Inpatients
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Solid organ transplant patients are on polypharmacy with multiple immunosuppressantsand the roles of transplant pharmacists are essential for managing the medications of such patients. In this study, the therapeutic interventions performed by transplant pharmacists in solid organtransplant settings were evaluated. A total of 439 drug-related interventions performed by transplant pharmacists for 310 solid organtransplant patients admitted to Yonsei University Severance Hospital from March 2012 to June 2014were analyzed retrospectively. The interventions were implemented in person before and during thecounseling of patients with organ transplant diagnoses on the Electronic Medical Record or on using a Severance Drug Utilization Review (S_DUR) program. The average acceptance rate of the interventions by the physician in charge was 76.3% and variedin the method of intervention and the type of transplanted organs. If the pharmacist made interventionsdirectly in person to the physician, the acceptance rate was greater than the rate through theS_DUR program (235 out of 264 [89.0%] versus 100 out of 175 [57.1%], p<0.001). There was an increasingtendency of acceptance rate in the order of heart (1 out of 5, 20.0%), lung (33 out of 46, 71.7%),liver (105 out of 143, 73.4%), kidney (195 out of 244, 79.9%) and simultaneous solid organ transplant (1out of 1, 100%) (p=0.02). The rates also showed an increasing trend in the order of renal dosing (54out of 97, 55.7%), drug interaction (44 out of 68, 64.7%), medication use without an indication (41 outof 52, 78.8%), incorrect order in prescription (47 out of 53, 88.7%), untreated indication (65 out of 70,92.9%), drug administration error made by the patient or nurses (44 out of 46, 95.7%) and patient’scomplaints (12 out of 12, 100%) (p<0.001). Transplant pharmacists played important roles in preventing medication errors in solid organtransplant settings. Therefore, transplant pharmacists should take an active part in the multidisciplinarytransplant team, with effective communications on the management of transplant patients’medication.
Abstract
Solid organ transplant patients are on polypharmacy with multiple immunosuppressantsand the roles of transplant pharmacists are essential for managing the medications of such patients. In this study, the therapeutic interventions performed by transplant pharmacists in solid organtransplant settings were evaluated. A total of 439 drug-related interventions performed by transplant pharmacists for 310 solid organtransplant patients admitted to Yonsei University Severance Hospital from March 2012 to June 2014were analyzed retrospectively. The interventions were implemented in person before and during thecounseling of patients with organ transplant diagnoses on the Electronic Medical Record or on using a Severance Drug Utilization Review (S_DUR) program. The average acceptance rate of the interventions by the physician in charge was 76.3% and variedin the method of intervention and the type of transplanted organs. If the pharmacist made interventionsdirectly in person to the physician, the acceptance rate was greater than the rate through theS_DUR program (235 out of 264 [89.0%] versus 100 out of 175 [57.1%], p<0.001). There was an increasingtendency of acceptance rate in the order of heart (1 out of 5, 20.0%), lung (33 out of 46, 71.7%),liver (105 out of 143, 73.4%), kidney (195 out of 244, 79.9%) and simultaneous solid organ transplant (1out of 1, 100%) (p=0.02). The rates also showed an increasing trend in the order of renal dosing (54out of 97, 55.7%), drug interaction (44 out of 68, 64.7%), medication use without an indication (41 outof 52, 78.8%), incorrect order in prescription (47 out of 53, 88.7%), untreated indication (65 out of 70,92.9%), drug administration error made by the patient or nurses (44 out of 46, 95.7%) and patient’scomplaints (12 out of 12, 100%) (p<0.001). Transplant pharmacists played important roles in preventing medication errors in solid organtransplant settings. Therefore, transplant pharmacists should take an active part in the multidisciplinarytransplant team, with effective communications on the management of transplant patients’medication.
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