{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:19:50Z","timestamp":1787681990878,"version":"build-2784847793"},"reference-count":16,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Calcineurin inhibitors (CNIs) are essential in immunosuppressive therapy after solid organ transplantation (SOT). Their narrow therapeutic index and inter\u2010 and intra\u2010individual variability require therapeutic drug monitoring (TDM), but optimal monitoring frequency remains unclear. This retrospective observational cohort study evaluated the impact of a pharmacist\u2010developed protocol to standardize and reduce CNI monitoring frequency on the number of CNI measurements, the achievement of CNI TDM target, and resource utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data was collected retrospectively from adult liver, kidney, and lung transplant patients hospitalized between February 1 and July 31 of 2023 and 2024 at the Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM). CNI measurements per patient per week, prescription quality and patient safety were compared before and after the protocol's implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      520 hospitalizations were included (254 pre\u2010 and 266 post\u2010intervention hospitalizations). Primary analysis showed an adjusted mean reduction of 0.9950 CNI measurements per patient per week (95% CI, 0.6398 to 1.3502;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.0001), corresponding to a 14.0% decrease. Secondary analysis revealed no significant differences in achieving CNI TDM target or dose adjustments between groups. CNI\u2010related adverse effects were similar in both groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The development and implementation of a new protocol by pharmacists to standardize and reduce the frequency of CNI monitoring significantly decreased the number of CNI measurements per hospitalized patient, without compromising the achievement of CNI TDM target or patient safety. This approach highlights a valuable strategy for hospitals to manage costs effectively amidst increasing financial pressures without affecting patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70633","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T16:14:47Z","timestamp":1785341687000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Planning Intermittent CalciNeurin Inhibitor Controls\u2014The piCNIc Retrospective Cohort Study"],"prefix":"10.1111","volume":"40","author":[{"given":"Veronica","family":"Bellissimo","sequence":"first","affiliation":[{"name":"Faculty of Pharmacy Universit\u00e9 De Montr\u00e9al  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilia","family":"Tran","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy Universit\u00e9 De Montr\u00e9al  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ga\u00eblle","family":"Bernard\u2010Tessier","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy Universit\u00e9 De Montr\u00e9al  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Simon","family":"Denault","sequence":"additional","affiliation":[{"name":"Pharmacy Department Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM) Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Pelletier","sequence":"additional","affiliation":[{"name":"Pharmacy Department Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM) Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea\u2010Adelina","family":"Statie","sequence":"additional","affiliation":[{"name":"Pharmacy Department Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM) Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Letarte","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy Universit\u00e9 De Montr\u00e9al  Montreal Quebec Canada"},{"name":"Pharmacy Department Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM) Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevi\u00e8ve","family":"Huard","sequence":"additional","affiliation":[{"name":"Hepatology Department Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM) Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Morisset","sequence":"additional","affiliation":[{"name":"Pneumology Department Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM) Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy Universit\u00e9 De Montr\u00e9al  Montreal Quebec Canada"},{"name":"Pharmacy Department Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM) Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"StatPearls","author":"Safarini O. 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Accessed December 12 2024 https:\/\/pdf.hres.ca\/dpd_pm\/00045498.PDF."},{"key":"e_1_2_11_12_1","unstructured":"Prograf (Tacrolimus) Product Monograph.Astellas Pharma;2019. Accessed December 12 2024 https:\/\/pdf.hres.ca\/dpd_pm\/00050217.PDF."},{"key":"e_1_2_11_13_1","unstructured":"Envarsus (Tacrolimus Prolonged\u2010Release Tablets) Product Monograph.Endo Ventures Ltd;2019. Accessed December 12 2024 https:\/\/pdf.hres.ca\/dpd_pm\/00049663.PDF."},{"key":"e_1_2_11_14_1","unstructured":"Medication Guidelines for Solid Organ Transplants.BC Transplant;2021. Accessed December 12 2024 http:\/\/www.transplant.bc.ca\/Documents\/Health%20Professionals\/Clinical%20guidelines\/Clinical%20Guidelines%20for%20Transplant%20Medications.pdf."},{"key":"e_1_2_11_15_1","unstructured":"Neoral (Cyclosporine) Product Monograph.Novartis Pharma;2015. Accessed December 12 2024 https:\/\/www.novartis.com\/ca\u2010en\/sites\/novartis_ca\/files\/neoral_scrip_f.pdf."},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088\u2010200443100\u201000001"},{"key":"e_1_2_11_17_1","unstructured":"Liste de prix 2021\u20102022.Centre hospitalier de l'Universit\u00e9 de Montr\u00e9al;2021. 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