Pharmacist-linked smartphone app reduces medication errors for transplant recipients
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Kidney transplant recipients utilizing a smartphone app that provided pharmacist-led medication management, including telehealth visits, experienced reduced medication errors and were less likely to be hospitalized than controls.
“Medication safety issues are predominant contributors to poorer health outcomes following kidney transplantation and lead to increased health care utilization,” David J. Taber, PharmD, MS, BCPS, of the Medical University of South Carolina, said in a press release about the study. “Clinical pharmacists have the unique education and training to help identify these issues early on and take action to mitigate downstream consequences. Additionally, mobile health technologies have emerged as a new tool to supplement current health practices and improve outcomes.”
Using the potential of such mobile health technologies, Taber and colleagues developed an app that provided patients with a list of their medication regimens (automatically updated from the electronic medical record), medication reminders, surveys on adverse events, as well as home-based blood pressure and glucose monitoring. In addition, participants engaged in risk-based televisits with a pharmacist.
“Televisits enabled the pharmacist to conduct medication reviews to identify any medication safety issues, ensure accurate medications through transitions of care, screen for drug interactions, and provide recommendations to the participant,” the researchers wrote.
To test the efficacy of the app, 136 participants who underwent transplantation 6 to 36 months prior were randomized to either an intervention or control group (both groups received usual care, defined here as having serial lab monitoring and routine clinic visits with a pharmacist for 6 months after transplant).
Although all study participants experienced at least one medication error during the 12-month study period (a total of 1,385 medication errors for control group vs. 614 for the intervention group), a multivariable model showed those using the app were 61% less likely to experience a medication error, 45% less likely to experience an adverse event of grade 3 or higher and 54% less likely to be hospitalized.
“It is paramount that we identify innovative strategies to help manage medication safety issues, and the integration of mobile health-based interventions and clinical pharmacist leadership represents a promising opportunity,” Taber said of the findings.
In an accompanying editorial, Wendy L. St. Peter, PharmD, and Timothy D. Aungst, PharmD, contended that while the study is well-designed, it is necessary to conduct a thorough economic analysis (as noted by the investigators). The analysis, according to the researchers, should examine a variety of costs, including those related to device and data plans, as well as costs to train patients to use the app and pharmacist time.
“Demonstration of cost-effective data-driven pharmacist care utilizing digital health services will be instrumental in enhancing value-based care in patients with kidney diseases,” they wrote.
Healio Nephrology previously reported on a study that demonstrated the potential of a smartphone app to help patients with chronic kidney disease better manage their medications. More on the app, which was shown to increase patient engagement and reduce medication discrepancies, can be found here.
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