Barriers and enablers shaping kidney transplant care delivery: Insights from Iraqi pharmacists

Abstract

Background Kidney transplant care in low-resource countries is often affected by multiple factors, including workforce constraints, fragmented communication, and medication access challenges. Given pharmacists’ involvement in medication management and regular patient follow-up, this study was designed to explore transplant care delivery in Iraq from pharmacists’ perspectives. Method Qualitative data were collected using face-to-face, semi-structured interviews with all eligible pharmacists from the two major governmental hospitals in Baghdad caring for kidney transplant recipients. Afterwards, data were analyzed using Braun and Clarke’s reflexive thematic analysis approach. Results This study included 13 pharmacists, 5 of whom were working in the clinical transplant wards, whereas the remaining 8 were working in the outpatient consultation setting. Four descriptive themes were identified: Dispensing-centered practice within a constrained and evolving pharmacist role, fragmented yet adaptive interprofessional collaboration, patient education as an informal and inconsistently delivered practice, and medication availability within a constrained and variably regulated supply system. Conclusion This study highlights the adaptive approaches used by pharmacists in an attempt to maintain medication access and patient support with the available resources. However, the study findings also highlight challenges that extend beyond the capacity of individual pharmacists to resolve and suggest the need for more structured organizational support, clearer communication pathways, and an integrated system to strengthen Iraqi transplant care practices within comparable governmental settings.

The authors' abstract, as published at the source. PLoS ONE, 2026 · DOI ↗