{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:30:53Z","timestamp":1782487853959,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,2,21]],"date-time":"2018-02-21T00:00:00Z","timestamp":1519171200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100011068","name":"Saint Luc Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100011068","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Prophylaxis with valganciclovir reduces the incidence of cytomegalovirus (<jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>) infection following solid organ transplant (<jats:styled-content style=\"fixed-case\">SOT<\/jats:styled-content>). Under\u2010dosing of valganciclovir is associated with an increased risk of <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> infection and development of ganciclovir\u2010resistant <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An automated electronic health record (<jats:styled-content style=\"fixed-case\">EHR<\/jats:styled-content>)\u2010based, pharmacist\u2010driven program was developed to optimize dosing of valganciclovir in solid organ transplant recipients at a large transplant center. Two cohorts of kidney, pancreas\u2010kidney, and liver transplant recipients from our center pre\u2010implementation (April 2011\u2010March 2012, n\u00a0=\u00a0303) and post\u2010implementation of the optimization program (September 2012\u2010August 2013, n=263) had demographic and key outcomes data collected for 1\u00a0year post\u2010transplant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 1\u2010year incidence of <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> infection dropped from 56 (18.5%) to 32 (12.2%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.05) and the incidence of breakthrough infections on prophylaxis was cut in half (61% vs 34%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03) after implementation of the dose optimization program. The hazard ratio of developing <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> was 1.64 (95% CI 1.06\u20102.60, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.027) for the pre\u2010implementation group after adjusting for potential confounders. The program also resulted in a numerical reduction in the number of ganciclovir\u2010resistant <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> cases (2 [0.7%] pre\u2010implementation vs 0 post\u2010implementation).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An <jats:styled-content style=\"fixed-case\">EHR<\/jats:styled-content>\u2010based, pharmacist\u2010driven valganciclovir dose optimization program was associated with reduction in <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> infections.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12849","type":"journal-article","created":{"date-parts":[[2018,1,23]],"date-time":"2018-01-23T13:33:17Z","timestamp":1516714397000},"source":"Crossref","is-referenced-by-count":11,"title":["Impact of electronic health record\u2010based, pharmacist\u2010driven valganciclovir dose optimization in solid organ transplant recipients"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2122-492X","authenticated-orcid":false,"given":"David","family":"Hensler","sequence":"first","affiliation":[{"name":"Northwestern Memorial Hospital  Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad L.","family":"Richardson","sequence":"additional","affiliation":[{"name":"Northwestern Memorial Hospital  Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joslyn","family":"Brown","sequence":"additional","affiliation":[{"name":"Carolinas HealthCare System  Charlotte NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Tseng","sequence":"additional","affiliation":[{"name":"Alexion Pharmaceuticals  New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phyllis J.","family":"DeCamp","sequence":"additional","affiliation":[{"name":"Transplant Management Group  San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Northwestern University Feinberg School of Medicine  Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Pawlowski","sequence":"additional","affiliation":[{"name":"Northwestern Medicine Enterprise Data Warehouse  Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Ho","sequence":"additional","affiliation":[{"name":"Divisions of Nephrology Northwestern University Feinberg School of Medicine  Chicago IL USA"},{"name":"Division of Organ Transplantation Northwestern University Feinberg School of Medicine  Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3347-9671","authenticated-orcid":false,"given":"Michael 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