Review article

Polypharmacy in Renal Transplant Patients

Mirna Alebić

Abstract

The term polypharmacy implies taking ≥ 5 drugs per patient and the related health challenges resulting from adverse events and adverse drug reactions and their interactions. In patients who have undergone a solid organ transplant, it is often unavoidable due to the complexity of the pathology that led to the transplant, as well as the maintenance of homeostasis after the transplant. The passage of time since transplantation as well as increasingly complex therapeutic protocols increase the number of drugs used in patient care, which then increases the risks that polypharmacy entails. For this reason, clinical pharmacists have an indispensable place in modern medical teams, who with their knowledge in the field of pharmacotherapy can contribute to the safe, correct application of therapies, which is a special challenge in polypharmacy, and by timely identification of clinically significant drug interactions, improve the quality of life and overall treatment outcomes of this complex group of patients. The optimization of therapeutic protocols with systematic procedures begins with the identification of cases in which the existing or potential harm from taking individual and/or combinations of drugs exceeds the potential benefit for each individual patient in the context of individual expectations from treatment in terms of quality of life, current level of functioning, expected life expectancy, as well as individual value systems and preferences. The next step would be to consider an alternative approach, i.e. canceling or modifying the dose or method of taking medication, taking into account the possible effects of this intervention on the course of the disease, and in the case of transplanted patients, on preserving the function of the transplanted organ, as well as the patient’s general health to prevent deterioration and resolve symptoms. With the cooperation of clinicians and clinical pharmacists in the follow-up of transplant recipients in a multidisciplinary approach in considering and optimizing therapeutic protocols, it is possible to improve therapeutic outcomes and significantly reduce or completely eliminate adverse effects resulting from polypharmacy.

Keywords

polypharmacy; adverse events; adverse drug reactions; interactions; clinical pharmacist; renal transplantation; immunosuppressive

Hrčak ID:

315857

URI

https://hrcak.srce.hr/315857

Publication date:

9.4.2024.

Article data in other languages: croatian

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