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Influence of Pill Burden and Drug Cost on Renal Function After Transplantation
Author(s) -
Hardinger Karen L.,
Hutcherson Timothy,
Preston David,
Murillo Daniel
Publication year - 2012
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.2012.01032.x
Subject(s) - medicine , transplantation , pill , renal function , kidney transplantation , creatinine , pancreas transplantation , surgery , pharmacology
Study Objective To determine the influence of pill burden and drug cost on outcomes after renal transplantation. Design Retrospective medical record review. Setting Kidney and pancreas transplantation center. Patients Sixty‐eight adults who underwent kidney or kidney‐pancreas transplantation during 2007. Measurements and Main Results The median pretransplantation pill burden was 15 pills/day, which increased to 25 pills/day at 1 month after transplantation and returned to 16 pills/day by 1 year after transplantation. Pretransplantation pill burden was lower than the burden at 1, 3, 6, 12, and 24 months after transplantation (p<0.05). The mean pretransplantation drug cost of $1918/month was lower than the cost at 1 month after transplantation ($2564/mo, p=0.04) but was similar thereafter. Higher pretransplantation pill burden was associated with increased serum creatinine concentration at 6 months after transplantation (r=0.288, p=0.017). Higher pill burdens at 1 month (r=0.364, p=0.002), 3 months (r=0.332, p=0.006), and 6 months (r=0.374, p=0.002) were associated with increased 3‐month serum creatinine concentration. Higher drug costs were associated with increased serum creatinine concentrations throughout the study. Conclusion Higher pretransplantation pill burden and higher drug cost may be associated with poor renal function after transplantation. Further study addressing factors associated with nonadherence is needed.