Effects of medication education pilot program in living versus deceased donor kidney transplant recipients

Purpose: Medication adherence is crucial for transplant recipients as non-adherence can result in increased risk of rejection and graft loss. Early education prior to transplant may help improve patient understanding of transplant medication regimens and increase adherence following transplant. Methods: A clinic-based, pre-transplant medication education program for living donor recipients was instituted at our center in addition to the standard posttransplant inpatient education for all transplant recipients. Living donor kidney transplant patients and their caregivers received education on medications, including immunosuppressive and anti-infective agents, and infection prevention from the clinic transplant pharmacist and nurse coordinator approximately a week prior to the transplant surgery. Both living and deceased donor kidney transplant recipients received standard post-transplant inpatient education from the inpatient transplant pharmacist. At the follow up clinic visit, a questionnaire was utilized to evaluate the patient\u27s knowledge regarding medication and post-transplant care to evaluate knowledge retention. Results: Of the 114 patients educated over a two year period utilizing this protocol, 86 patients completed the questionnaire and were included in the analysis. When evaluating the characteristics of the kidney donors, 48 (56%) were deceased donor (63% standard criteria deceased donors, 33% donation after cardiac death donors) and 38 (44%) were living donors (55% living related donors and 45% living unrelated donors). There was 1 patient (2%) that received simultaneous pancreas-kidney transplant and 1 (2%) patient that received en-bloc kidney transplant. Most patients came to the visit with at least one support person, but 4 patients (10.5%) were alone in the living donor group and 11 patients (23%) in the deceased donor group when educated. The questionnaire was taken on an average of 7 days (± 9.8 days) after discharge. The average pre-education score in the living donor group was 86 ± 9.2% and 82 ± 12.1% in the deceased donor group. Conclusion: An additional education session delivered prior to transplant by the pharmacist and nurse coordinator resulted in improved patient scores and knowledge of post-transplant medications. Further studies with larger patient population are needed to determine the significance of additional patient education prior to transplant and its correlation to clinical outcomes