Evaluation of Counseling from Pharmacist to Liver Transplant Patients

Abstract

Background: The prescribed immunosuppressants for organ transplant patients were adjusted according to blood level. Other drugs were also adjusted. These patients frequently have polypharmacy, which leads to increased risk for drug-related problems (DRPs).

Objectives: This study aimed to determine DRPs detected during counseling to organ transplant patients by pharmacist at pre-doctor visit comparing to counseling at pre- and post- doctor visit.

Method: A retrospective, observational study was performed in the Liver Transplant Clinic from January 1, 2021 to December 31, 2022. In 2021, pharmacists counseled patients at pre-doctor visit (pre-counseling) but in 2022, pharmacists counseled twice at pre- and post- doctor visit (pre- and post-counseling). Pharmacists identified DRPs using the PCNE Classification Version 9.1 and DRPs were grouped into preventable DRPs and non-preventable DRPs.

Results: In 2021, 15 DRPs were found from 240 pre-counseling. Four categories of DRPs were identified: patient-related problems (11, 73.3%), adverse drug effects (2, 13.3%), drug-use process problems (1, 6.7%), and drug selection problems (1, 6.7%). Thirteen (86.7%) of those were classified as preventable DRPs. In 2022, 19 DRPs were found from 314 pre- and post-counseling. Four categories of DRPs were identified: drug-use process problems (6, 31.6%), adverse drug effects (6, 31.6%), patient-related problems (5, 26.3%), and drug selection problems (2, 10.5%). Thirteen (68.4%) of those were classified as preventable DRPs.

Conclusion: The results of the study indicate that pre- and post- counseling from pharmacists can significantly reduce patient-related problems, and tend to decrease non-adherence when compared with pre- counseling alone.