# Improving Transplant Medication Safety through a TEchnology and Pharmacist (ISTEP) Intervention in Veterans

> **NIH VA I01** · RALPH H JOHNSON VA MEDICAL CENTER · 2021 · —

## Abstract

Anticipated Impacts on Veterans Health Care: The first three essential strategies listed within the VA's
Blueprint for Excellence encompass plans to improve care to vulnerable Veterans, deliver high quality care
through achieving the “Triple Aim” and leverage the use of technology to improve the efficiency of care
delivery. The intervention this grant proposes focuses on improving medication safety and care
coordination within a high risk vulnerable Veteran population, leverages the use of informatics and analytics
to support this intervention, and aims to demonstrate improved care at reduced costs through the
pharmacist intervention; thus, perfectly aligning with these three essential components of the Blueprint. The
overarching goal of this study is to develop a feasibly deployable, technology-enabled intervention that will
demonstrate substantial improvements in immunosuppressant medication safety, clinical outcomes and
health care costs in Veteran organ transplant recipients; demonstrating this through a randomized controlled
trial will provide sufficient evidence to further develop a VA-specific pharmacist learning collaborative aimed
at improving care and reducing costs for Veteran organ transplant recipients across the entire VA system.
Background: Organ transplant is the gold-standard treatment for patients with end organ diseases of the
kidney, liver, heart and lungs, as it substantially improves survival and quality of life. Over the past 20
years, the use of contemporary immunosuppression has reduced the risk of acute rejection rates by
upwards of 80%; yet long-term allograft survival remains suboptimal. Studies have demonstrated that
causes of late graft loss is predominantly driven by immunosuppression adverse events and late allograft
rejection episodes from medication errors and non-adherence, which encompass issues directly related to
medication safety. Our research demonstrates that medication errors occur in nearly two-thirds of
transplant recipients, leading to hospitalization in 1 in 8 recipients. Recipients that develop significant
medication errors are at considerably higher risk of graft loss, leading to higher costs and mortality. Thus, in
order to improve medication safety and long-term outcomes in transplant recipients, enhancements in
immunosuppressant therapy management is needed.
Objectives: The central hypothesis for the ISTEP study (Improving Transplant Medication Safety through a
TEchnology and Pharmacist Intervention) is that pharmacist-led immunosuppressant therapy management,
facilitated through the use of innovative technology, will significantly improve immunosuppressant safety and
clinical outcomes in Veteran transplant recipients.
Methods: This is a 24-month, prospective, multicenter, cluster-randomized controlled clinical trial at 10 sites,
randomizing 5 sites to standard clinical care and 5 to standard care and the technology-enabled pharmacist
intervention. The technology component of this intervention co...

## Key facts

- **NIH application ID:** 10186502
- **Project number:** 5I01HX002130-04
- **Recipient organization:** RALPH H JOHNSON VA MEDICAL CENTER
- **Principal Investigator:** David J. Taber
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-03-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10186502

## Citation

> US National Institutes of Health, RePORTER application 10186502, Improving Transplant Medication Safety through a TEchnology and Pharmacist (ISTEP) Intervention in Veterans (5I01HX002130-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10186502. Licensed CC0.

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