Pharmacists’ perspectives on monitoring adherence to treatment in Cystic Fibrosis
- 450 Downloads
Background Cystic Fibrosis (CF) management requires complex treatment regimens but adherence to treatment is poor and has negative health implications. There are various methods of measuring adherence, but little is known regarding the extent of adherence measurement in CF centres throughout the UK and Ireland. Objective To determine the adherence monitoring practices in CF centres throughout the UK and Ireland, and to establish CF pharmacists’ views on these practices. Setting UK and Ireland Cystic Fibrosis Pharmacists’ Group’s annual meeting (2014). Methods A questionnaire was designed, piloted and distributed to pharmacists attending the UK and Ireland Cystic Fibrosis Pharmacists’ Group’s annual meeting (2014). The main outcome measures were the methods of inhaled/nebulised antibiotic supply and the methods used to measure treatment adherence in CF centres. The questionnaire also ascertained the demographic information of participating pharmacists. Closed question responses were analysed using descriptive statistics. Open questions were analysed using content analysis. Results Twenty-one respondents (84 % response) were included in the analysis and were mostly from English centres (66.7 %). Detailed records of patients receiving their inhaled/nebulised antibiotics were lacking. Adherence was most commonly described to be measured at ‘every clinic visit’ (28.6 %) and ‘occasionally’ (28.6 %). Patient self-reported adherence was the most commonly used method of measuring adherence in practice (90.5 %). The availability of electronic adherence monitoring in CF centres did not guarantee its use. Pharmacists attributed an equal professional responsibility for adherence monitoring in CF to Consultants, Nurses and Pharmacists. Seventy-six percent of pharmacists felt that the current adherence monitoring practices within their own unit were inadequate and associated with the absence of sufficient specialist CF pharmacist involvement. Many suggested that greater specialist pharmacist involvement could facilitate improved adherence monitoring. Conclusion Current adherence knowledge is largely based on self-report. Further work is required to establish the most appropriate method of adherence monitoring in CF centres, to improve the recording of adherence and to understand the impact of increased specialist pharmacist involvement on that adherence.
KeywordsCystic Fibrosis Ireland Medication adherence Treatment monitoring United Kingdom
We thank members of the Cystic Fibrosis Pharmacists’ Group for their participation in this work.
This work was funded by the Gilead Fellowship programme. However, they did not have a direct role in the data collection and analysis, nor did they have any editorial input into this paper.
Conflicts of interest
The authors (Karen Mooney, Cristín Ryan and Damian G Downey) have no conflicts of interest to declare.
- 1.Jain M, McColley SA. Breathing in America: Diseases, progress and hope [Internet]. United States: American Thoracic Society; 2010 [cited 21 Sept 2015]. 8p. Available from: http://www.ukmi.nhs.uk/filestore/ukmianp/2014PrescribingOutlook-NewMedicines2014-FINAL.pdf.
- 3.World Health Organisation. Adherence to long-term therapies: Evidence for action [Internet]. 2003 [cited 21 Sept 2015]. Available from: http://www.who.int/chp/knowledge/publications/adherence_report/en/.
- 16.NHS Health Research Authority. Does my project require review by a Research Ethics Committee? [Internet]. 2013 [cited 24 Nov 2015]. Available from: http://www.hra.nhs.uk/documents/2013/09/does-my-project-require-rec-review.pdf.
- 22.UK Medicines Information. Prescribing Outlook: New Medicines [Internet]. Sept 2014 [cited 21 Sept 2015]. Available from: http://www.ukmi.nhs.uk/filestore/ukmianp/2014PrescribingOutlook-NewMedicines2014-FINAL.pdf.
- 24.Tommelein E, Mehuys E, Van Hees T, Adriaens E, Van Bortel L, Christiaens T, et al. Effectiveness of pharmaceutical care for patients with chronic obstructive pulmonary disease (PHARMACOP): a randomized controlled trial. Br J Clin Pharmacol. 2014;77(5):756–66.CrossRefPubMedPubMedCentralGoogle Scholar