Addition Of Pharmacist In A Pediatric Cystic Fibrosis Clinic
BACKGROUND: Poor medication adherence is a common problem for patients with Cystic Fibrosis, and leads to poor health outcomes. Medication adherence is impacted by patient, healthcare provider and treatment related factors.
OBJECTIVE: To increase the percentage of patients receiving appropriate CF medications by introducing a pharmacist to the CF team.
MATERIALS AND METHODS: In 2015, a pharmacist was incorporated into the CF Clinic to increase: medication knowledge, accuracy of the medication record, evaluation of drug therapies for efficacy and toxicity, and medication adherence. The percentage of patients receiving each CF medication, pulmonary function tests and exacerbations were collected annually. Data were compared from 2014-2017 to evaluate the impact of the intervention.
RESULTS: Greater than 90% of our patients received hypertonic saline in 2017, compared to 50% in 2014. Greater than 85% of our patients with approved mutations received CFTR modulators in 2017 compared to 25% in 2014. The percent of patients receiving azithromycin decreased from 100% in 2014 to 80% in 2017. Median FEV1 and median FVC percent predicted for patients increased in 2017. Percent of patients with one or more pulmonary exacerbations increased from 2014 to 2017.
CONCLUSION: Overall the percentage of patients receiving appropriate CF medications increased, in part by the addition of a pharmacist. However, additional barriers continue to hinder patient adherence to CF medications, further quality improvement interventions are needed to further improve patient medication adherence. Patient knowledge and EMR accuracy will be assessed in the future.