Impact of electronic health record‐based, pharmacist‐driven valganciclovir dose optimization in solid organ transplant recipients

Abstract

An EHR-based, pharmacist-driven valganciclovir dose optimization program was associated with reduction in CMV infections.

A pharmacist‐driven antimicrobial stewardship intervention targeting cytomegalovirus viremia in ambulatory solid organ transplant recipients

“…In a systematic review of antimicrobial stewardship in outpatient settings based on studies published between 2000 and 2013, ASPs were found to be associated with reduction in unnecessary prescribing, but much remained unknown regarding impact on patient outcomes as these were infrequently part of the study designs . Recently, a retrospective study was conducted to evaluate the impact of a pharmacist‐driven optimization program of valganciclovir dosing in SOT recipients . The investigators found the intervention led to a reduced incidence of CMV infection, reduced incidence of breakthrough infections, and reduced number of ganciclovir‐resistant CMV in the post‐implementation group .…”

“…Recently, a retrospective study was conducted to evaluate the impact of a pharmacist‐driven optimization program of valganciclovir dosing in SOT recipients . The investigators found the intervention led to a reduced incidence of CMV infection, reduced incidence of breakthrough infections, and reduced number of ganciclovir‐resistant CMV in the post‐implementation group . Our study corroborates these findings and expands upon the impact pharmacists can have through real‐time CMV surveillance, decisions surrounding treatment initiation, and drug therapy optimization.…”

The development and implementation of stewardship initiatives to optimize the prevention and treatment of cytomegalovirus infection in solid-organ transplant recipients

“…Current literature describing CMV stewardship initiatives have focused on either treatment or prophylaxis of CMV, and interventions mostly focus on appropriate dosing of GCV derivatives. 46,47 We believe that appropriate allotment of resources can expand the scope of CMV stewardship and thereby address the current clinical need. 48 When designing our center-specific initiative, we did not limit scope, which resulted in identification of a multitude of stewardship targets.…”

Antimicrobial stewardship in transplant patients

“…Therapeutic drug monitoring of antibacterial and antifungal agents is requisite in transplantation and insights into target antiviral levels for CMV prophylaxis are emerging and have recently been studied in kidney transplant recipients [24]. Pharmacy-driven interventions, leveraging the electronic medical record (EMR) and clinical decision support for dose optimization have led to earlier therapy, faster eradication, less CMV infections, and less ganciclovir resistance [25,26].…”