​​Dipika Munyal, Dave Paterson and Shabdis Djazayeri
(From left to right) Clinical Pharmacist Dipika Munyal, double lung transplant recipient Dave Paterson and Transplant Outpatient Pharmacy Operations Leader  Shabdis Djazayeri do a final check on Dave’s medications before he goes home to Ottawa.  Djazayeri and team were able to prepare all his medications in one hour after his prescription was ordered, ensuring a seamless and fast transition home.  (Photo: UHN News​)

Dave Paterson, 72, t​akes 38 pills a day to keep his new lungs healthy. It's a lot to carefully juggle, but he's cheerful about it, because now he can breathe, walk and even eat much better than before his transplant.

And now - after being monitored for about three months after his December 2014 double lung transplant - he is ready to go home to Ottawa. Dave is relieved and confident that he can manage his own care because the Transplant Outpatient Pharmacy will be there every step of the way to help him with his customized medications. They will even deliver his medications to his doorstep for free – something they will do anywhere in Ontario – a measure of their superb service standards for patients who have been discharged from the hospital.

The UHN Transplant Outpatient Pharmacy is Canada's first and only transplant specialty pharmacy, with a number of awards – such as the prestigious national 2015 Patient Care Enhancement Award - celebrating its safe and seamless care for patients and expanded services geared towards ongoing patient education and support after hospital discharge.

"Our circle of care is integrated between inpatients and outpatients," says Esther Fung, Director of Pharmacy, Corporate Business and Outpatient Operations. "We have the expertise to follow a transplant patient's care and carefully customized prescriptions, preventing readmissions from side effects, drug interactions or not following a prescribed drug regimen."

In fact, not adhering to the complex drug regimen is the most prevalent cause of preventable loss of the transplanted organ.

"We're passionate about making a difference," says Karen Chuk, Manager, TGH Outpatient Pharmacies. "Every member of our Transplant Outpatient Pharmacy team makes sure that our services are geared towards helping patients understand what they are taking, why they are taking it, and how they must take a drug.

"We help ease that transition from hospital to home. We don't let go of a patient's hand when he or she leaves the hospital," she says. 

Dave and his wife, Laurie Lyon, talk about how much they have benefitted from this approach. Dave shows a customized computer printout with his colour-coded schedule and praises Clinical Pharmacist Dipika Munyal who went over everything in detail to ensure that Dave understood what and why he was taking specific medications, when he needed to take them, and if food or drink was required with a specific drug.

They are especially grateful that the pharmacists easily and seamlessly helped him transition from liquid to oral medications, which meant that Dave no longer had to wake up at midnight to take one of his liquid doses.

"The pharmacists set us up for success," beams Laurie, adding that "they are a great back-up. We feel very secure that they are there for the rest of Dave's life to answer any questions and help us if we need it."

Jennifer Harrison, Pharmacy Clinical Site Leader at TGH, notes that transplant patients on average take about 21 doses of medications a day and that the Transplant Outpatient Pharmacy provides "an additional level of safety" with one-to-one consults, customized teaching and strategies to help patients remember to take their medications, and extra checks of the prescription against a patient's hospital medical record to prevent drug interactions and ensure accurate medication doses.

These services help identify and prevent problems for patients and are a major safeguard not available elsewhere.

"Even we were surprised at the reactions of patients after we opened our pharmacy in 2013," Harrison says. "We've had lots of positive feedback from them, about how much they rely on our services and support." ​

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