Canadian Pharmacists Journal - May/June 2019 - CPH7
Changing Paradigm in Management of Post-Transplant Patients: Pharmacist Role
Graft rejection remains a major barrier to successful transplantation and is largely attributed to:
* Chronic immunologic processes leading to destruction of graft38
* Non-adherence to immunosuppression
- Meta-analysis of 10 studies demonstrated that odds of graft failure increased 7-fold in non-adherent vs. adherent
subjects following kidney transplantation39
A "one-size-fits-all" approach to post-transplant management fails to address individual needs of patients and may
be contributing to the lack of improvement in long-term outcomes.38 The changing paradigm in management of posttransplant patients involves consideration of four patient-specific domains (predictive, preventive, personalized, and
participatory medicine) when caring for transplant patients.38 In particular, pharmacists can play key roles in improving
participatory and personalized domains.
Domain
Pharmacist role
Personalized Immunosuppression regimens and posttransplant monitoring
Communicate with transplant centre before initiating
any change in treatment
Participatory medicine catered to individual transplant
recipients
Reinforce the importance of adherence and address
any questions the patient may have
Factors Contributing to Non-Adherence After Transplantation40, 41
Strategies for Promoting Immunosuppressant Therapy Adherence42, 43
Medication-taking
Assess for barriers to appropriate medication-taking
Develop system of reminder cues; use reminder devices
Implement behaviour-changing strategies
Simplify immunosuppression regimens (reduce the number and frequencies of
medications, where possible, with appropriate follow-up)
Provide medication organizational tools such as dosettes, blister packaging
Provide individualized patient education via a variety of methods
Modify regimen to decrease adverse effects, where possible
Monitor compliance with surveys, laboratory work, and prescription refills
Use a non-judgmental approach to the discussion of adherence
Social support
Involve family members and friends as a support system
Urge care team members to develop rapport with patient
Team work with the transplant specialist
7
Canadian Pharmacists Journal - May/June 2019
Table of Contents for the Digital Edition of Canadian Pharmacists Journal - May/June 2019
Regulation and innovation in practice – Not a “drug interaction”?
Dietary sodium and the health of Canadians
Professional abstinence: What does it mean for pharmacists?
Canada’s new Healthy Eating Strategy: Implications for health care professionals and a call to action
Report from the 2018 National Summit on Wicked Problems in Community Pharmacy
Medical abortion: A practice tool for pharmacists
Community-based management of epistaxis: Who bloody knows?
The pharmacist’s role in successful deprescribing through hospital medication reconciliation
Pharmacists to improve hypertension management: Guideline concordance from North America to Europe
The patient experience in a community pharmacy mental illness and addictions program
Community pharmacists’ experiences with the Saskatchewan Medication Assessment Program
Cross-Canada updates
The conference experience—Making it yours
Canadian Pharmacists Journal - May/June 2019 - Intro
Canadian Pharmacists Journal - May/June 2019 - Cover1
Canadian Pharmacists Journal - May/June 2019 - Cover2
Canadian Pharmacists Journal - May/June 2019 - 137
Canadian Pharmacists Journal - May/June 2019 - 138
Canadian Pharmacists Journal - May/June 2019 - 139
Canadian Pharmacists Journal - May/June 2019 - 140
Canadian Pharmacists Journal - May/June 2019 - 141
Canadian Pharmacists Journal - May/June 2019 - 142
Canadian Pharmacists Journal - May/June 2019 - Regulation and innovation in practice – Not a “drug interaction”?
Canadian Pharmacists Journal - May/June 2019 - 144
Canadian Pharmacists Journal - May/June 2019 - 145
Canadian Pharmacists Journal - May/June 2019 - 146
Canadian Pharmacists Journal - May/June 2019 - Dietary sodium and the health of Canadians
Canadian Pharmacists Journal - May/June 2019 - Professional abstinence: What does it mean for pharmacists?
Canadian Pharmacists Journal - May/June 2019 - 149
Canadian Pharmacists Journal - May/June 2019 - 150
Canadian Pharmacists Journal - May/June 2019 - Canada’s new Healthy Eating Strategy: Implications for health care professionals and a call to action
Canadian Pharmacists Journal - May/June 2019 - 152
Canadian Pharmacists Journal - May/June 2019 - 153
Canadian Pharmacists Journal - May/June 2019 - 154
Canadian Pharmacists Journal - May/June 2019 - 155
Canadian Pharmacists Journal - May/June 2019 - 156
Canadian Pharmacists Journal - May/June 2019 - 157
Canadian Pharmacists Journal - May/June 2019 - Report from the 2018 National Summit on Wicked Problems in Community Pharmacy
Canadian Pharmacists Journal - May/June 2019 - 159
Canadian Pharmacists Journal - May/June 2019 - Medical abortion: A practice tool for pharmacists
Canadian Pharmacists Journal - May/June 2019 - 161
Canadian Pharmacists Journal - May/June 2019 - 162
Canadian Pharmacists Journal - May/June 2019 - 163
Canadian Pharmacists Journal - May/June 2019 - Community-based management of epistaxis: Who bloody knows?
Canadian Pharmacists Journal - May/June 2019 - 165
Canadian Pharmacists Journal - May/June 2019 - 166
Canadian Pharmacists Journal - May/June 2019 - 167
Canadian Pharmacists Journal - May/June 2019 - 168
Canadian Pharmacists Journal - May/June 2019 - 169
Canadian Pharmacists Journal - May/June 2019 - 170
Canadian Pharmacists Journal - May/June 2019 - 171
Canadian Pharmacists Journal - May/June 2019 - 172
Canadian Pharmacists Journal - May/June 2019 - 173
Canadian Pharmacists Journal - May/June 2019 - 174
Canadian Pharmacists Journal - May/June 2019 - 175
Canadian Pharmacists Journal - May/June 2019 - 176
Canadian Pharmacists Journal - May/June 2019 - The pharmacist’s role in successful deprescribing through hospital medication reconciliation
Canadian Pharmacists Journal - May/June 2019 - 178
Canadian Pharmacists Journal - May/June 2019 - 179
Canadian Pharmacists Journal - May/June 2019 - Pharmacists to improve hypertension management: Guideline concordance from North America to Europe
Canadian Pharmacists Journal - May/June 2019 - 181
Canadian Pharmacists Journal - May/June 2019 - 182
Canadian Pharmacists Journal - May/June 2019 - 183
Canadian Pharmacists Journal - May/June 2019 - 184
Canadian Pharmacists Journal - May/June 2019 - 185
Canadian Pharmacists Journal - May/June 2019 - The patient experience in a community pharmacy mental illness and addictions program
Canadian Pharmacists Journal - May/June 2019 - 187
Canadian Pharmacists Journal - May/June 2019 - 188
Canadian Pharmacists Journal - May/June 2019 - 189
Canadian Pharmacists Journal - May/June 2019 - 190
Canadian Pharmacists Journal - May/June 2019 - 191
Canadian Pharmacists Journal - May/June 2019 - 192
Canadian Pharmacists Journal - May/June 2019 - Community pharmacists’ experiences with the Saskatchewan Medication Assessment Program
Canadian Pharmacists Journal - May/June 2019 - 194
Canadian Pharmacists Journal - May/June 2019 - 195
Canadian Pharmacists Journal - May/June 2019 - 196
Canadian Pharmacists Journal - May/June 2019 - 197
Canadian Pharmacists Journal - May/June 2019 - 198
Canadian Pharmacists Journal - May/June 2019 - 199
Canadian Pharmacists Journal - May/June 2019 - 200
Canadian Pharmacists Journal - May/June 2019 - 201
Canadian Pharmacists Journal - May/June 2019 - 202
Canadian Pharmacists Journal - May/June 2019 - 203
Canadian Pharmacists Journal - May/June 2019 - Cross-Canada updates
Canadian Pharmacists Journal - May/June 2019 - 205
Canadian Pharmacists Journal - May/June 2019 - 206
Canadian Pharmacists Journal - May/June 2019 - The conference experience—Making it yours
Canadian Pharmacists Journal - May/June 2019 - 208
Canadian Pharmacists Journal - May/June 2019 - 209
Canadian Pharmacists Journal - May/June 2019 - 210
Canadian Pharmacists Journal - May/June 2019 - 211
Canadian Pharmacists Journal - May/June 2019 - 212
Canadian Pharmacists Journal - May/June 2019 - Cover3
Canadian Pharmacists Journal - May/June 2019 - Cover4
Canadian Pharmacists Journal - May/June 2019 - CPH1
Canadian Pharmacists Journal - May/June 2019 - CPH2
Canadian Pharmacists Journal - May/June 2019 - CPH3
Canadian Pharmacists Journal - May/June 2019 - CPH4
Canadian Pharmacists Journal - May/June 2019 - CPH5
Canadian Pharmacists Journal - May/June 2019 - CPH6
Canadian Pharmacists Journal - May/June 2019 - CPH7
Canadian Pharmacists Journal - May/June 2019 - CPH8
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