Significant hospitalization cost savings to the payer with a pharmacist-led mobile health intervention to improve medication safety in kidney transplant recipients

Abstract

Addressing medication errors and safety issues are paramount to improving long-term health outcomes in those with chronic medical conditions. 1 This is particularly the case in kidney transplant recipients, who are at high risk for having medication errors leading to deleterious outcomes, most saliently adverse drug events and hospitalizations. 2 Several studies have demonstrated that medication errors leading or contributing to hospitalization occur in one in eight to 10 kidney transplant recipients. [3][4][5] Furthermore, medication nonadherence, which most consider to be a medication safety issue, is the predominant risk factor for late acute rejection and based on a

Pharmacy Practice Standards for Outpatient Nephrology Settings

“…Examples include identifying and resolving medication therapy problems, deprescribing unnecessary or harmful medications, 37 improving blood pressure and albuminuria postacute kidney injury, 38 reducing risk categorization for patients with kidney transplant, 39 reducing hospital lengths of stay 35 and hospital readmissions among patients on dialysis, 36 and reducing medication errors, adverse events, and hospitalizations among transplant recipients 40 with associated cost savings. 41 Recent publications in primary care also demonstrated reduced physician burnout when pharmacists joined the care team as well as high levels of patient satisfaction. 42 , 43 , 44 Recently published clinical practice guidelines specifically highlight the important role of pharmacists in kidney care.…”

The economics of medication safety

“…Macro-level strategies ("systems oriented") can be understood as either regulatory or economic. Regulatory interventions are laws or policies that aim to affect prescribing patterns through restrictions or incentives (Suleman and Movik, 2019 [127]). Examples include pharmaceutical registration and approval, prescribing restrictions (e.g., prescription fill limits, prescribing restricted to specialists) and dispensing…”

“…Financial incentives have been used by several jurisdictions influence prescribers' behavior. These incentives can include laws, regulations or orders made by public or private payers, NGOs or insurers (Suleman and Movik, 2019 [127]). Although a number of countries employ economic strategies, evidence is lacking on whether or not they are effective and if so, what harms might accrue (Rotar, Van Den Berg and Klazinga, 2020 [126]).…”

Education Standards for Pharmacists Providing Comprehensive Medication Management in Outpatient Nephrology Settings

“… 3 , 5 , 7 , 8 , 9 Integration of pharmacists into the multidisciplinary kidney transplant team has also led to improved medication safety. 10 , 11 , 12 , 13 , 14 …”

“…3,5,[7][8][9] Integration of pharmacists into the multidisciplinary kidney transplant team has also led to improved medication safety. [10][11][12][13][14] Pharmacists can offer more advanced care through comprehensive medication management (CMM), a patient-centered process of optimizing medications that is delivered by a pharmacist collaborating on an interprofessional team to improve health outcomes. 15 CMM is of particular importance given the new value-based kidney care models that are being developed in response to the Advancing American Kidney Health executive order enacted in 2019.…”