Evaluation of Medication Education and Adherence of Patients Being Evaluated for Kidney and/or Pancreas Transplantation

Purpose: 1) Assess prior experience with medication education, medication therapy management (MTM), and medication resources of pre-kidney and/or pancreas transplant patients; 2) identify barriers to adherence; and 3) evaluate patient perceptions regarding receiving pharmacist-provided MTM. 

Methods: Candidates for kidney and/or pancreas transplant were asked to participate in a verbal survey during initial pre-transplant evaluation (March-April 2012).  The survey included open-ended, multiple choice, and likert-type questions addressing participants’ experience with medication education, medication taking habits, and perceived barriers to medication adherence. Baseline demographics were collected, including criteria required for MTM eligibility.  Participants completed a medication adherence assessment [Modified Morisky Scale (MMS)]. 

Results: Twenty-five patients were surveyed, with a mean age of 48 (±10) years.   Fourteen (56%) were male, 17 (68%) Caucasian, and 10 (40%) with Medicare Part D.  Patients took a median of 10 (range 4-24) medications and had 6 (range 2-12) chronic diseases, including 24 (96%) with end-stage renal disease, 24 (96%) with hypertension, and 13 (52%) with diabetes. MMS adherence scores were high in both knowledge and motivation.  On a 4-item scale [a lot, some, a little, or none], 14 (56%) reported they knew “some” information about new prescription medication(s) when leaving the doctor’s office and 16 (64%) reported knowing more about the medication(s) after leaving the pharmacy. No patient reported having had a pharmacist-provided MTM session, though 2 (8%) reported a previous nurse or doctor visit to specifically review medications.  Nineteen (76%) thought it would be helpful to have a pharmacist appointment, and 56% indicated they would probably schedule one if given the opportunity.  Sixty percent of patients reported remembering to take medications as their biggest adherence challenge.

Conclusion: Many pre-kidney and/or pancreas transplant patients are interested in pharmacist-provided MTM, though none have received it.  Patients may benefit from MTM due to the complexity of regimens and the importance of adherence.