Using A Work System Framework to Investigate Pharmacists' Roles in Cystic Fibrosis Management

Abstract

OBJECTIVE Cystic fibrosis (CF) is a genetic disease that requires complex, lifelong treatment regimens to maintain health and reduce disease progression. The aims of this study were 1) to gain the perspectives of multiple health professions to understand medication and well-being challenges of people living with CF; and 2) to apply the Systems Engineering Initiative for Patient Safety (SEIPS) model to further identify opportunities for pharmacists to support people with CF. METHODS Health care professionals were recruited from a Cystic Fibrosis Center in the Midwest, to participate in audio-recorded semistructured interviews. Topics examined during the interviews included medication education for patients as well as experiences with outpatient, specialty, and community pharmacists. The themes assessed during the pharmacist interviews included support for people living with CF, preferences in conducting medication education, and pharmacist-specific counseling. Interview transcripts were thematically analyzed into categories to determine major themes. Prevalent codes were categorized into 5 major themes guided by the SEIPS model. Interrater reliability was strong (kappa = 0.94). RESULTS Five major themes were identified: 1) patient tasks; 2) external environment; 3) organizational conditions; 4) patient medication education; and 5) pharmacists' roles and tasks. Professionals identified the importance of the pharmacist on the multidisciplinary CF care team to enhance patient-centered care for people living with CF. CONCLUSIONS This study highlights health care professionals' views on the unique skillset that pharmacists add to the care team, including a reduction in medication errors, improved adherence, and overall enhanced patient care.

Longitudinal Study of Therapeutic Adherence in a Cystic Fibrosis Unit: Identifying Potential Factors Associated with Medication Possession Ratio

“…Within the multidisciplinary management of CF, as a multisystemic disease, the role of the hospital pharmacist is relevant. The pharmacist must coordinate and communicate closely with the medical team to provide the correct pharmacological prescription [ 33 , 34 ]. They can also provide us with TA information, a notable aspect to evaluate, among others, when deterioration or poor evolution is observed in a patient with CF.…”

“…They can also provide us with TA information, a notable aspect to evaluate, among others, when deterioration or poor evolution is observed in a patient with CF. Likewise, although the declaration of the SARS-CoV-2 pandemic and the state of alert was a fortuitous event [ 22 ], as hospital pharmacies arranged mechanisms to deliver medication to patients’ homes, no deterioration in TA was observed [ 33 , 34 , 35 ]. On the other hand, the pharmaceutical cost of the treatments required by CF patients is usually very high, and adequate adherence is necessary to obtain the expected results [ 36 ].…”