Plain language summaries of research

This is a plain language summary of an original research article. The views expressed are those of the author(s) and reviewer(s) at the time of publication.

The issue: how do liver transplant recipients access their immunosuppression medication?

A group of specialist transplant pharmacists working at liver transplant hospitals in the UK wanted to better understand how liver transplant recipients receive their transplant anti-rejection medication (immunosuppression). This is important to understand, because there are differences across the UK in the ways people receive their immunosuppression medication after their transplant.

What happened?

Specialist transplant pharmacists shared an anonymous online patient satisfaction survey with liver transplant recipients, promoted through patient support groups and networks. This survey asked people how they receive their medication and about their levels of satisfaction.

324 people completed the survey in total, of which more than 70% were 3 years post-transplant, and 9% were less than 1 year post-transplant.

What did they find out?

Access to medication

Around half of survey respondents stated they receive their immunosuppression medication from their transplant hospital (51%), 30% receive it from their GP, 12% receive it via homecare (a company that delivers prescriptions from the hospital), and only 5% receive their immunosuppression medication from their referral hospital.

Satisfaction

• 87% of survey respondents stated they were satisfied or very satisfied with their method of medication supply.
• The area with the highest level of dissatisfaction was 'ease of re-ordering', with 10% saying they were dissatisfied or very dissatisfied with this part of their service.
• The area with the lowest level of satisfaction was 'help available in an emergency', with 63% of respondents stating they were satisfied or very satisfied, and 30% stating they were neither satisfied nor dissatisfied with this part of their service.
• When people were asked to describe their experience of immunosuppression medication supply, the words used most often were efficient and good supply .

Why is this important?

These results are important to understand because all ways of getting immunosuppression medication to patients are facing some difficulties associated with growing numbers of liver transplant patients.

Since 2013, GPs in England are no longer paid by the NHS to prescribe liver transplant immunosuppression medications. As a result, liver transplant hospitals in England have been prescribing this type of medication instead. Over time, GPs in England might start asking transplant hospitals to take over this responsibility entirely.

GPs will continue to handle these prescriptions in Scotland and Northern Ireland.

It is also important to understand patient satisfaction in this area because many patients are facing issues, such as long waits, not getting enough medicine, and needing better support. For people still receiving their medication from their GP, supply issues seem to be a common problem.

While services across the country may differ for a variety of reasons, they are working hard with what they have, and trying to improve where they can.

What happens next?

A useful next step could be for other specialist pharmacists at individual liver transplant centres to adapt the survey and have a more in-depth look at the experiences patients they serve. This would help to maintain good service, and to identify areas that could be improved.

If you are worried about what this might mean for your immunosuppression medication supply, please contact the clinical team (doctors, nurses or pharmacists) that usually see you for transplant follow-up appointments. It is recommended that you continue getting your immunosuppression medication supplies in your usual way, unless your service advises you otherwise.