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Background: We aimed to identify care processes and structures that were independently associated with higher medication adherence among young transplant recipients. Methods: We conducted a prospective, observational cohort study of 270 prevalent kidney, liver, and heart transplant recipients 14–25 years old. Patients were ≥3 months post‐transplant, ≥2 months post‐discharge, and followed in one of 14 pediatric or 14 adult transplant programs in Canada. Patients were enrolled between June 2015 and March 2018 and followed for 6 months. Adherence was assessed at baseline, 3, and 6 months using the BAASIS© self‐report tool. Patients were classified as adherent if no doses were missed in the prior 4 weeks. Transplant program directors and nurses completed questionnaires regarding care organization and processes. Results: Of the 270 participants, 99 were followed in pediatric programs and 171 in adult programs. Median age was 20.3 years, and median time since transplant was 5 years. At baseline, 71.5% were adherent. Multivariable mixed effects logistic regression models with program as a random effect identified two program‐level factors as independently associated with better adherence: minimum number of prescribed blood draws per year for those >3 years post‐transplant (per 1 additional) (OR 1.12 [95% CI 1.00, 1.26]; p =.047), and average time nurses spend with patients in clinic (per 5 additional minutes) (OR 1.15 [1.03, 1.29]; p =.017). Conclusion: Program‐level factors including protocols with a greater frequency of routine blood testing and more nurse time with patients were associated with better medication adherence. This suggests that interventions at the program level may support better adherence. [ABSTRACT FROM AUTHOR]

Introduction: Currently there is a lack of published data examining the clinical impact of pharmacy learners on patient care outcomes in acute care. A collaborative of hospital pharmacists in Canada established consensus on eight clinical pharmacy key performance indicators (cpKPIs) representing essential patient processes of care. Of the eight cpKPIs, admission medication reconciliation has been established as a cornerstone patient care process. The implementation of cpKPI measurement creates an opportunity to quantify pharmacy learner contribution to patient care. Aim: To determine if the presence of pharmacy learners partnering with pharmacists is associated with an increased number of patients receiving admission medication reconciliation (AMR). Methods: In this prospective observational study, pharmacists and learners (on 5‐week rotations) tracked patients receiving AMR in the electronic health record from 25 January to 17 July 2016. The number of patients receiving AMR were compared during timeframes when a learner was present (intervention) to when a learner was not present (control). Results: In the main analysis of 30 learner‐pharmacist pairs with 4684 patients, 1136 patients received AMR in the intervention group versus 887 patients in the control group (adjusted for 5 weeks). The number of patients receiving AMR in the presence of a pharmacy learner partnered with a pharmacist (median = 43, IQR = 23–59) was significantly increased compared to the presence of a pharmacist alone (median = 36, IQR = 17–53, p < 0.001). Learners partnered with pharmacists to perform AMR for 41% of the patients. Conclusion: Overall, pharmacy learners partnering with pharmacists increased the number of patients receiving AMR. [ABSTRACT FROM AUTHOR]