Impact of pharmacy services on cystic fibrosis medication adherence

Zobell, Jeffery T.; Schwab, Elizabeth; Collingridge, David; Ball, C. D.; Nohavec, Robert; Asfour, Fadi

doi:10.1002/ppul.23743

Cited by 26 publications

(62 citation statements)

References 22 publications

(36 reference statements)

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“…Hence, the difference across studies may be due, in part, to unknown regional differences in patient selection. Similar to our results, Zobell et al noted trends toward reduced hospitalizations after the pharmacy team intervention (though not significant given the sample size). Emergency room claims indicated a much lower rate among our program patients, as well as reduced level of ER costs, compared to the control group.…”

Section: Discussionsupporting

confidence: 89%

“…Medication nonadherence among patients with cystic fibrosis has been found to be a predictor of both lung function decline and pulmonary exacerbations requiring IV antibiotics . A 2014 study noted that patients with low or moderate adherence to pulmonary medications were more likely to have CF‐related or all‐cause hospitalizations compared to patients with high adherence .…”

Section: Introductionmentioning

confidence: 99%

“…In 2017, Zobell et al published the first study to demonstrate a positive impact of pharmacy services on medication adherence for CF patients. This study found significantly higher adherence to dornase alfa after initiation of an integrated pharmacy team model and dedicated CF clinic pharmacist compared to before the interventions.…”

Section: Introductionmentioning

confidence: 99%

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Outcome evaluation of a pharmacy‐based therapy management program for patients with cystic fibrosis

Kirkham

Staskon

Hira

et al. 2018

Pediatric Pulmonology

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ObjectiveTo compare medication adherence, pulmonary exacerbations, healthcare utilization, and costs for patients with cystic fibrosis (CF) who utilized a pharmacy‐based therapy management program to a matched control group. We hypothesized that patient management services would be associated with better medication adherence, and thus require fewer visits to the emergency room or hospitalizations.MethodsThis retrospective, observational cohort study used claims data from the MORE2 claims Registry®. The sample consisted of CF patients, aged 6+, who had ≥1 pharmacy claim for inhaled tobramycin, inhaled aztreonam, ivacaftor, or dornase alfa from 6/2/2014‐5/31/2015. Adherence was measured as proportion of days covered (PDC). Propensity score matching and multivariable regression techniques were used to compare outcomes in program participants to matched controls.ResultsOf the 236 intervention and 724 control patients meeting selection criteria, 202 were propensity‐matched from each cohort. Relative to the control cohort, program patients had 23% higher mean PDC for tobramycin (IRR = 1.23, P = 0.01) and were twice as likely to be adherent to tobramycin (PDC ≥ 80%) than matched controls (OR = 2.14, P = 0.04). Program patients had fewer ER visits (IRR = 0.52, P < 0.01) and slightly lower ER costs (IRR = 0.66, P = 0.06) than the control patients.ConclusionA pharmacy‐based therapy management program for CF patients was associated with higher adherence to inhaled tobramycin and lower ER rates. Pharmacies that provide therapy management can support effective CF care management.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Outcome evaluation of a pharmacy‐based therapy management program for patients with cystic fibrosis

Kirkham

Staskon

Hira

et al. 2018

Pediatric Pulmonology

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“…We are writing this letter to provide an update of the continuing impact and sustainability of the integrated pharmacy team model and a dedicated cystic fibrosis (CF) clinic pharmacist on medication adherence and hospitalizations to the article “Impact of pharmacy services on cystic fibrosis medication adherence” by Zobell and colleagues …”

mentioning

confidence: 99%

Impact of pharmacy services on cystic fibrosis medication adherence: Update

Zobell

Collingridge

Asfour

2018

Pediatric Pulmonology

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“…There is a need for the collation of data on the use of CFTR modulators in pregnancy and lactation not only to validate safety, but also because there may be a role for such therapy to prevent the complications of CF that develop in utero , such as meconium ileus, pancreatic insufficiency and congenital absence of the vas deferens. Pharmacists have demonstrated that they can play important clinical, research and cost‐saving roles in multidisciplinary CF clinics . Despite this, UK, US and Australian guidelines for CF clinics state pharmacists remain ‘recommended’ as part of the multidisciplinary clinic as opposed to mandatory for some other allied health disciplines.…”

Section: Remaining Challengesmentioning

confidence: 99%

Cystic fibrosis: novel therapies, remaining challenges

Coulthard

2018

Pharmacy Practice and Res

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Developments in the treatment of cystic fibrosis (CF) over the past 50 years have seen survival extend from death in the first decade of life to an expected median survival now approaching 50 years of age. Adults with CF now outnumber children, a dramatic shift if one considers that many adult CF clinics were only established in the 1980s. Together with speciality multidisciplinary clinics, new medicines and their aggressive application have played a pivotal role in this achievement. Although there is still no clinically available cure, novel therapies targeting the underlying basic defects have resulted in major beneficial clinical outcomes and quality of life for those living with CF, albeit at significant cost. Although this review concentrates on currently available novel pharmacological therapies, the important role of potential ‘cures’, such as gene therapy, must not be overlooked. The complex drug interactions of the new agents, the need for detailed patient education and research opportunities in CF in general support the role of the specialist pharmacist in CF clinics.

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Impact of pharmacy services on cystic fibrosis medication adherence

Abstract: The study demonstrated that pharmacy services improved adherence to dornase alfa.

Cited by 26 publications

References 22 publications

Outcome evaluation of a pharmacy‐based therapy management program for patients with cystic fibrosis

Outcome evaluation of a pharmacy‐based therapy management program for patients with cystic fibrosis

Impact of pharmacy services on cystic fibrosis medication adherence: Update

Cystic fibrosis: novel therapies, remaining challenges

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