Korean J Transplant.  2023 Nov;37(Suppl 1):S4. 10.4285/ATW2023.F-5640.

Drug related problems in Liver Transplant Clinic at Maharaj Nakorn Chiang Mai Hospital

• Koomeaung P
• Saenton J

• KMID: 2551571
• DOI: http://doi.org/10.4285/ATW2023.F-5640

Abstract

Background
Maharaj Nakorn Chiang Mai Hospital has had a liver transplant clinic since 2015. The most importance factor is adherence of immunosuppressive drugs, as nonadherence can lead to graft rejection. Pharmacists have joined liver transplant clinic since 2020 and do medication reconciliation, check adherence, and check drug interactions. The aim of this study was to find drug-related problems compared between precounseling alone and pre-post counseling.
Methods
A cross-sectional observational study was performed in the liver transplant clinic at Maharaj Nakorn Chiangmai from January 2021 to December 2022. In year 2021, pharmacists did precounseling but in year 2022, pharmacists did pre- and postcounseling. Pharmacists identified drug-related problems using tool Pharmaceutical Care Network Europe (PCNE) Classification ver 9.1 and grouped drug-related problems into two groups: preventable drug related problems and nonpreventable drug related problem.
Results
In year 2021, pharmacists did precounseling for 240 visits. Pharmacists found 15 drug-related problems in four categories: patient-related problems (11, 73.3%), side effects from medications (2, 13.3%), drug-use process problems (1, 6.7%), and drug selection problem (1, 6.7%). Thirteen (86.7%) of those were classified as preventable drug related problems. In year 2022, pharmacists did pre- and post-counseling for 314 visits. Nineteen drug-related problems were found and grouped into the follow categories: drug-use process (6, 31.6%), side effect (6, 31.6%), patient-related problems (5, 26.3%), and drug selection (2, 10.5%). Of those, 13 (68.4%) were determined to be preventable drug-related problems.
Conclusions
The results of the study indicate that pre- and postcounseling from pharmacists can decrease patient-related problems, especially nonadherence, when compared with precounseling alone.