SPOTLIGHT ON FAIRVIEW HEALTH SERVICES PART II
According to the latest guidelines for cystic fibrosis (CF) published in U.S. Pharmacist, pharmacists are an important part of counseling patients with CF. The Fairview CF medication ahderence rate is 70% higher than among patients at retail pharmacies.
In Part 1 of our interveiw with pharmacists from the Fairview specialty pharmacy, we discussed some of the keys to that success (eg, close team work, ongoing staff training). In Part II we focus on the primary barriers to treatment adherence CF patients face and how Fairview specialty pharmacists are working to reduce them.
PC: What are some common reasons patients don’t take their medication or follow their treatment plans? Are there some solutions that tend to work generally, or is it more on an individual, case-by-case basis?
Dr Ehlert: I think there are a couple of common themes. A lot of it comes down to treatment burden. What we ask these patients to do every single day, just to maintain their health, is a lot. There's only so much we can do about that, but we can work with them, talk through their daily schedule and help figure out how best to incorporate things into their daily routine. We can ask a patient if there is something they are most likely to miss or forget or that they keep forgetting—is it a specific medication or does their schedule on a certain day of the week make it hard to fit in some aspect of care? How can we help that patient create a routine that is realistic for their life; that will fit their schedule so that they will be able to adhere to it?
"...there are a couple of common themes. A lot of it comes down to treatment burden."
Dr Ehlert: Sometimes the barrier may be patient expectations. The problem may be that the patient doesn’t fully understand how the medication is going to work and what it is actually doing for them or they don’t have realistic expectations for the treatment—and so they stop it. It’s not doing what they think it should be doing. I think that's becoming a big issue, particularly with the new CFTR modulators coming out.
"Sometimes the problem may be that the patient doesn’t fully understand how
the medication is going to work and what it is actually doing for them..."
An important piece of overcoming that barrier to adherence is upfront education. When a patient starts a new therapy, we need to make sure that they understand how it works and what to expect: Are there side effects? How will they feel? How long will it take to see/feel some kind of change? Will they actually notice anything different? So that if they say their life isn’t changing now that they started the new medication they will understand that it doesn’t mean the medication isn't working. We need to manage expectations.