BACKGROUND
This study evaluated the influence of pharmaceutical care (PhC) in the intraindividual variability of dose-corrected whole blood tacrolimus trough concentrations, adherence to immunosuppressive therapy and clinical outcomes.
METHODS
We randomized 128 kidney transplants recipients to receive pharmaceutical care consisted of predefined instructions provided by a pharmacist (PhC group, n=64) or standard nurse staff instructions (Control group, n=64) from day 3 to day 90 after kidney transplantation. The study was powered to detect at least 50% reduction in the coefficient of variation (%CV), calculated from six dose-corrected whole blood tacrolimus trough concentrations, in the PhC group. Patient adherence was evaluated using BAASIS questionnaire.
RESULTS
There was no difference in the %CV comparing PhC and Control group (31.4±12.3 vs. 32.5±16.1%, p= 0.673). There were no differences in the proportion of patients showing tacrolimus concentrations within predefined target concentrations in each study visit. There was no difference in the proportion of non-adherent patients at day 28 (17 vs. 26% p=0.135) and day 90 (27 vs. 25% p=0.457) based on BAASIS questionnaire answers, respectively. There were no differences in clinical outcomes.
CONCLUSION
Universal pharmaceutical care in addition to standard nurse staff instruction was not associated with reduced intraindividual variability of dose-corrected whole blood tacrolimus trough concentrations or improved adherence.