医学
他克莫司
槽水位
肾移植
肾移植
随机对照试验
血液浓度
变异系数
药剂师
临床试验
内科学
移植
泌尿科
药店
护理部
统计
数学
作者
Adrieli Bessa,Cláudia Rosso Felipe,Pedro Hannun,Priscila BMS Sayuri,Magnus Felix,Priscila Ruppel,Alexandra Ferreira,Marina Pontello Cristelli,Laila Almeida Viana,Juliana Mansur,Geovana Basso,Wilson Aguiar,Hélio Tedesco‐Silva,José Osmar Medina Pestana
标识
DOI:10.1097/ftd.0000000000000299
摘要
Background: This study evaluated the influence of pharmaceutical care (PhC) in the intra-individual variability of dose-corrected whole blood tacrolimus (TAC) trough concentrations, adherence to immunosuppressive therapy and clinical outcomes. Methods: We randomized 128 kidney transplant recipients to receive PhC 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 6 dose-corrected whole blood TAC trough concentrations, in the PhC group. Patient adherence was evaluated using Basel Assessment of Adherence to Immunosuppressive Medication Scale (BAASIS) questionnaire. Results: There was no difference in the %CV comparing PhC and control group (31.4% ± 12.3% versus 32.5% ± 16.1%, P = 0.673). There were no differences in the proportion of patients showing TAC concentrations within predefined target concentrations in each study visit. There was no difference in the proportion of nonadherent patients at day 28 (17% versus 26%, P = 0.135) and day 90 (27% versus 25%, P = 0.457) based on BAASIS questionnaire answers, respectively. There were no differences in clinical outcomes. Conclusions: Universal PhC in addition to standard nurse staff instruction was not associated with reduced intra-individual variability of dose-corrected whole blood TAC trough concentrations or improved adherence.
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