The purpose of this article is to provide a description of a clinical pharmacy services program implemented in a renal transplant clinic to improve medication access and adherence as well as health and economic outcomes among renal transplant recipients (RTRs). Following a team-based planning process and an informal survey of RTRs, a clinical pharmacy service intervention was implemented in the Medical College of Georgia renal transplant clinic. As part of the intervention, a clinical pharmacist reviewed and optimized medication therapy, provided instructions on how to take medication, and assisted with enrollment into medication assistance programs. Significant differences were found between RTRs who did and did not receive clinical pharmacy services on measures of adherence, health, economics, and quality of life. Clinical pharmacy services, as described in this article, have a positive impact on renal transplant recipients’ medication adherence, health and economic outcomes, and health-related quality of life. The findings described here suggest that clinical pharmacy services are a viable and effective option for improving care for RTRs in an outpatient clinic setting.

Objective: Programs have been established to help underserved, solid-organ transplant recipients and other patient populations address the burden of medication regimen costs. The purpose of this study was to describe one such program, the Medication Access Program (MAP), and the population of solid-organ transplant recipients it serves. An additional objective was to compare characteristics of recipients whose MAP enrollment was continued versus those who were discontinued during the annual re-enrollment period. Methods: Enrollment into MAP is based on referral from a pharmacist or another health care professional/transplant team member. To enroll, a recipient must complete an application which includes information about demographics, health care coverage, income, and medication regimen. To maintain enrollment, patients must complete a renewal application on an annual basis. Data were collected from renewal applications for 2012 and 2011 (for those who did not return the 2012 renewal applications). Chi-square analyses and Student's t-test for independent samples were conducted to compare the characteristics of those who renewed their MAP enrollment in 2012 and those who were discontinued because they did not return the renewal application. Multivariate stepwise logistic regression was conducted to determine variables predictive of MAP continuation status. Results: In total, 246 recipients were included. The majority qualified for Medicare (67.9%), did not qualify for Medicaid (69.9%), and did not have private health care coverage (63.8%). Significantly more continued recipients qualified for Medicare compared to discontinued recipients (P=0.002). Discontinued recipients had a greater number of past discontinuations than continued recipients (P=0.01). In the logistic regression analysis, qualifying for Medicare was significantly associated with continuation status (P=0.001). Conclusion: MAP is designed to increase medication access for low-income solid-organ transplant recipients through enrollment into medication assistance programs, education regarding medication therapy, and availability of medication assistance programs. Health care providers should use historical monitoring to identify high risk patients and implement programs that will facilitate continuity of care.

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