Clinical and economic evaluation of pharmacists' contribution to patient care on a multi-disciplinary liver transplant team.

Objectives: We aimed to describe and to evaluate the clinical and economic implications of pharmacists' interventions as members of the liver transplant team for hospitalized liver recipients.

Methods: Retrospective descriptive and cost-benefit analysis of documented pharmacist interventions for hospitalized patients from January 2010 to June 2012 was conducted. The type of drug-related problems (DRPs) was categorized. The clinical significance of pharmacist interventions was rated using five scales by two professionals. The cost avoidance was estimated based on the probability that an adverse drug event (ADE) would have occurred without intervention using previously reported additional costs for ADE treatment.

Results: A total of 1,880 interventions were documented for 420 liver transplant recipients. The most common DRP was "need additional drug therapy" (42.6%), followed by "dosage problems" (23.5%). The most common drug class addressed by intervention was antimicrobials (51.4%). Most interventions were rated as more than clinically "significant". Analysis showed that pharmacist activities related to potential ADE prevention had a clear cost-benefit with a net cost-benefit € 94,009 and a cost-benefit ratio of 3.8.

Conclusion: This study demonstrated the positive impact of clinical pharmacists on the care of hospitalized liver transplant patients in terms of both clinical and economic outcomes.