What is the current status of transplant pharmacy services in China? A nationwide cross-sectional survey.

Abstract

Pharmacists are vital to the multidisciplinary care for transplant patients, but the workforce of their work in China remains unclear. To assess the current status of transplant pharmacists' work in China through a national workforce survey to evaluate service provision across transplantation stages and pharmacist capacity. Nationwide cross-sectional questionnaire-based study (25 March-1 April 2024) involving 91 transplant centres performing>90% of China's organ transplants. Pharmacy items and duration provided to patients by pharmacists at each transplant centre and used to calculate full-time equivalents (FTEs). Service provision varied substantially across centres, with only 0.8 pharmacists per 100 transplant patients nationally. Current workforce require 2.6 FTEs/100 transplants for comprehensive services, reducible to 1.2 FTEs if non-clinical duties are excluded. Key challenges included service inconsistency, limited patient coverage and inadequate standardisation/digitalisation. Primary barriers were excessive non-service workloads and insufficient performance incentives. Addressing these issues is an effective way to change the current status of pharmacy services for transplant recipients in China. A national workforce survey revealed significant gaps in transplant pharmacy services in China, particularly in standardisation and digitalisation. To address these issues, key steps include reducing non-essential workloads for transplant clinical pharmacists, enhancing performance incentives, expanding the number of transplant pharmacists and developing standardised service protocols.