Impact of Integrated Clinical Pharmacist on Care of Patients with Cystic Fibrosis in a Rural Health Care Setting
by Josey Poppens, PharmD, Tonja Larson, PharmD, BCPS, BCACP, Natalee Felber, PharmD, BCPS, Joshua Freedman, MD, MPH, Brittany Graves, BSN, RN, Lee Cody, MD
Abstract:
Objectives:
Patients diagnosed with cystic fibrosis (CF) are prescribed extensive medication regimens and have a high treatment burden, leading to poor medication adherence. The Cystic Fibrosis Foundation (CFF) recommends including a clinical pharmacist in the integrated healthcare team; however, limited research exists regarding this recommendation’s impact on patient health. Our pilot study assessed the impact of a clinical pharmacist integrated into an interdisciplinary CF team to improve medication adherence using medication management services that follow CF guidelines.
Methods:
This prospective, quality improvement pilot initiative included patients diagnosed with CF, ranging from newborns to adults, enrolled in our rural health system’s CF clinic between August 2023 and April 2024. The primary objective focused on subjective patient reports of medication adherence and general pharmacy refill history of cystic fibrosis transmembrane conductance regulator (CFTR) modulator. Through patient interaction, the clinical pharmacist determined current medication adherence and discussed opportunities to improve. The pharmacist collected refill history and missed dose information throughout the study period. Key secondary objectives included pharmacist-identified drug therapy opportunities, medication reconciliation discrepancies, and patient education. Subjective data was collected using patient, caregiver, and CF medical team surveys. Drug therapy opportunities, patient education, and medication discrepancies were assessed.
Results:
For the primary objective, CFTR modulator refill history obtained from the patient’s pharmacy showed 88% of patients were receiving the medication on time with no gap in therapy. During this 4-month pilot initiative of patient discussions with the pharmacist, 20% of patients reported missing several doses of their CFTR modulator a week. Patients with poor CFTR modulator therapy adherence improved their medication adherence with integration of the pharmacist into the care team.
Conclusion:
Integration of a pharmacist in the outpatient CF clinic appointments was associated with an improvement in medication adherence. Providing patient education on medication adherence also enhanced patient care.
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2025 July/August Table of Contents
Abstract:
Objectives:
Patients diagnosed with cystic fibrosis (CF) are prescribed extensive medication regimens and have a high treatment burden, leading to poor medication adherence. The Cystic Fibrosis Foundation (CFF) recommends including a clinical pharmacist in the integrated healthcare team; however, limited research exists regarding this recommendation’s impact on patient health. Our pilot study assessed the impact of a clinical pharmacist integrated into an interdisciplinary CF team to improve medication adherence using medication management services that follow CF guidelines.
Methods:
This prospective, quality improvement pilot initiative included patients diagnosed with CF, ranging from newborns to adults, enrolled in our rural health system’s CF clinic between August 2023 and April 2024. The primary objective focused on subjective patient reports of medication adherence and general pharmacy refill history of cystic fibrosis transmembrane conductance regulator (CFTR) modulator. Through patient interaction, the clinical pharmacist determined current medication adherence and discussed opportunities to improve. The pharmacist collected refill history and missed dose information throughout the study period. Key secondary objectives included pharmacist-identified drug therapy opportunities, medication reconciliation discrepancies, and patient education. Subjective data was collected using patient, caregiver, and CF medical team surveys. Drug therapy opportunities, patient education, and medication discrepancies were assessed.
Results:
For the primary objective, CFTR modulator refill history obtained from the patient’s pharmacy showed 88% of patients were receiving the medication on time with no gap in therapy. During this 4-month pilot initiative of patient discussions with the pharmacist, 20% of patients reported missing several doses of their CFTR modulator a week. Patients with poor CFTR modulator therapy adherence improved their medication adherence with integration of the pharmacist into the care team.
Conclusion:
Integration of a pharmacist in the outpatient CF clinic appointments was associated with an improvement in medication adherence. Providing patient education on medication adherence also enhanced patient care.
Download PDF
2025 July/August Table of Contents