ABSTRACT
Purpose: Patients interact with healthcare providers (HCP) and pharmacists to manage medications. Little is known about the impact of COVID-19 on medication management. The purpose of this study was to describe medication management, HCP/pharmacist interactions, and adherence, including initiation, implementation and persistence, during the COVID-19 pandemic in kidney transplant (KT) patients and those on the KT wait list. Method(s): The IRB determined this study was exempt. Using a mixed methods design, 340 adults at a transplant center in the midwestern US were recruited. The Managing Medications in the Midst of a Pandemic Survey measured HCP/pharmacy encounters and medication management. The Basel assessment of adherence to medications scale measured medication adherence. Result(s): The sample average age was 58.2 years, 61% male, and 86% White. During the COVID-19 pandemic, 90% had/were currently practicing socially distancing, 87% had /were currently wearing a face mask when out in public, 19% had/were currently diagnosed with COVID-19, and 84% received the vaccine. Additional survey results include: Medication management: 82% percent plan/organize their own medications. Healthcare team interactions: 98% talked with their HCP since the beginning of social distancing;13% delayed seeing a HCP because of COVID-19 concerns. Pharmacy interactions: 11% changed their method of obtaining medications from pharmacy due to social distancing and 3.5% delayed refilling medications. Medication adherence-Initiation: 2.5% were prescribed a new medication but did not begin taking it. Medication adherence-Implementation: in the 4 weeks prior to the survey, 19% missed a dose, 6.7% skipped a dose, 16% took a medication more than 2-hour time difference from the prescribed time, and 2.5% altered prescribed amount. Medication adherence- Persistence: 3.4% stopped taking a prescribed medication without a doctor's order during the pandemic. Conclusion(s): A majority of the patients waiting for a KT and KT patients acted to prevent COVID-19 but some still contracted the virus. The pandemic changed medication management interactions with HCP and pharmacists. Adherence implementation problems were nearly 20%. Findings are relevant to transplant HCP and pharmacists, who must support patients attempting to manage and adhere to prescribed medications during the pandemic.