Implementation of an Outpatient Clinical Pharmacy Service at an Adult Cystic Fibrosis Center.

Abstract

Background: High treatment burden can adversely impact health outcomes in people with cystic fibrosis (PwCF). There is a continued need for medication adherence education and further research to evaluate impact of CF pharmacist interventions in an ambulatory care setting.

Objective(s): To evaluate whether pharmacist integration into an outpatient adult CF clinic can positively impact patient satisfaction and medication adherence through various pharmacist-based interventions.

Methods: At a single urban medical center, a clinical pharmacist on an adult CF care team conducted comprehensive counseling sessions with PwCF. During these visits, types of pharmacist interventions were documented. Patients were provided a baseline and post-counseling survey to assess satisfaction with the pharmacist visit. Adherence to cystic fibrosis transmembrane regulator (CFTR) modulator and mucolytics were tracked 12 months before and 12 months after the counseling session.

Results: A total of 723 pharmacist interventions were performed throughout 100 pharmacist visits in 100 PwCF. Most common interventions were inhaler technique education (17%), drug interaction identification (12%), provision of drug education material (12%), and medication refills (12%). Prior to any intervention, 97% of patients felt they could benefit from a pharmacist visit. Post-counseling survey results demonstrated that 98% of patients found pharmacist counseling to be beneficial. Medication adherence rate prior to pharmacy intervention was 81.9% for CFTR modulators and 62.5% for mucolytics, and 86.9% (p=0.143) and 63.6% (p=0.773), respectively, after pharmacist intervention.

Conclusion: Integration of a clinical pharmacist within the CF clinic can help improve satisfaction and understanding of medication use among PwCF. Nearly all PwCF favorably perceived pharmacist counseling. We report that various pharmacist interventions including optimizing medication use knowledge, reinforcing adherence strategies, and streamlining timely access to treatment can contribute to enhanced care of PwCF.