Improving Transplant Med Safety through a Pharmacist-Led, mHealth-Based Program

项目摘要 虽然目前使用的免疫抑制方案已大大降低了 急性排斥、长期移植物存活在肾移植中仍然是次优的。研究表明 药物不良事件和用药错误，这两者都包括用药安全问题，可能是一个 移植物丢失的主要原因。然而，尽管肾移植受者有高风险， 关于药物安全性事件，关于以下事件的发生率、病因和结局的信息有限： 用药错误和药物不良事件。我们的初步研究表明 重大用药错误，主要是由于患者相关因素，发生在近三分之二的 肾移植受者，导致每八个病人中就有一个住院治疗。的收件人 发生临床上显著的用药错误具有相当高的有害临床结果的风险， 最显著的是移植物丢失;这些患者还发生显著更多的药物不良事件， 急性排斥反应研究人员还证明了移动的健康的可行性和高度可接受性 （mHealth）技术用于弥合经常导致药物安全问题的沟通差距。 智能手机和家庭监控技术在这一人群中的渗透率非常高。 这些研究表明，药剂师授权，以患者为中心，基于移动健康的干预提供了 这是一个创新的和非常有前途的机会，以提高肾移植中的药物安全性。是 在此背景下，研究人员建议开展提高移植药物安全性的研究， 通过一项药剂师授权，以患者为中心，基于移动健康的干预（TRANSAFE Rx）研究。 TRANSAFE Rx研究的主要目标是证明药物安全性的显著降低 通过药剂师主导的， 移动健康支持，干预。进行这项研究将提供详细和新颖的信息， 该高风险人群中用药错误和药物不良事件的发生率、病因和结局; 同时也证明了这种干预措施在减少艾滋病毒/艾滋病的发生率和影响方面的有效性， 肾移植中的药物安全问题。这项研究的长期目标是证明一个 提高高危患者群体用药安全性的高效、高效和可部署的方法 其长期目标是在多个患者中传播这种有前途的技术和干预， 类型和医疗环境。

PROJECT SUMMARY Although the contemporary use of immunosuppression regimens have dramatically reduced the incidence of acute rejection, long-term graft survival continues to be suboptimal in kidney transplantation. Studies suggest that adverse drug events and medication errors, both of which encompass medication safety issues, may be a predominant cause of graft loss. However, despite kidney transplant recipients being at high-risk for medication safety events, there is limited information surrounding the incidence, etiologies and outcomes of medication errors and adverse drug events within this population. Our preliminary research has demonstrated that significant medication errors, predominantly due to patient-related factors, occur in nearly two-thirds of kidney transplant recipients, leading to hospitalization in one out of every eight patients. Recipients that develop clinically significant medication errors are at considerably higher risk of deleterious clinical outcomes, most significantly graft loss; these patients also develop substantially more adverse drug events, readmissions and acute rejections. Researchers have also demonstrated feasibility and high acceptability of mobile health (mHealth) technology use to bridge communication gaps that often lead to medication safety issues. Smartphone and home-based monitoring technology has a very high penetration rate within this population. These studies establish that a pharmacist-empowered, patient-centered, mHealth-based intervention provides an innovative and highly promising opportunity to improve medication safety in kidney transplantation. It is within this context that the investigators propose to conduct the Improving Transplant Medication Safety through a Pharmacist-Empowered, Patient-Centered, mHealth-Based Intervention (TRANSAFE Rx) study. The primary goal of the TRANSAFE Rx study is to demonstrate significant reductions in medication safety issues leading to reduced healthcare resource utilization in kidney transplantation through a pharmacist-led, mHealth-enabled, intervention. Conducting this study will provide detailed and novel information on the incidence, etiologies and outcomes of medication errors and adverse drug events in this high-risk population; while also demonstrating the effectiveness of this intervention on reducing the incidence and impact of medication safety issues in kidney transplantation. The enduring goals of this study are to demonstrate a highly effective, efficient and deployable method to improve medication safety in high risk patient populations with the long-term objective of disseminating this promising technology and intervention across multiple patient types and healthcare environments.