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Collaborative cystic fibrosis care: Implementation of a pharmacist annual exam

Background: Pharmacists are recommended members of the CF care team per the CF Foundation (CFF) center accreditation guidelines Our CF center has two integrated outpatient specialty pharmacists Our primary objective was to measure change in average patient satisfaction score before and after a pharmacist annual exam Secondarily, we quantified and categorized the interventions documented during the exam Methods: This is an ongoing prospective cohort study approved by our institutional internal review board The cohort is adult and pediatric patients at our CF center Before the exam, patients or caregivers (subjects) receive a satisfaction survey with 10 questions about pharmacy services;nine have a four-option Likert scale selection (strongly agree, agree, disagree, strongly disagree), two have a not-applicable option The tenth rates the interaction with the pharmacist from poor to excellent Responses are translated to numerical scores of 1-4 The survey is completed during the subject's scheduled visit at our CF center After the initial survey, the pharmacist performs a comprehensive annual exam The exam follows a standard format focusing on drug therapy optimization, medication access, medication reconciliation and patient education Immediately after the annual exam, the subject is given the same survey for data collection We performed a paired t-test on the total mean of the pre- and post-annual survey scores for statistical analysis of the primary endpoint We also tracked interventions and categorized them into four categories: drug therapy optimization, medication access, medication reconciliation, or patient education The pharmacist defines their intervention as an educational, logistical, or clinical action during the annual exam Results: Results are presented (Table) We collected 29 patient satisfaction surveys between 1/8/20-3/2/20 Mean overall satisfaction improved by 49% after an annual exam with a pharmacist The question, “After talking with the clinic pharmacist, I feel more confident to manage my medications” showed the greatest change Pharmacists made an average of 6 5 interventions per patient, with a total of 189 interventions across 29 patient exams Medication reconciliation was the most frequent intervention;modifying the electronic medical record medication list to reflect accurate use Conclusion: A pharmacist annual exam improves patient satisfaction These data suggest that patients find it beneficial to have a pharmacist in clinic as a required member of the care team The quantity of interventions suggest pharmacists should complete an annual exam as the CFF outlines for other required disciplines Limitations include survey bias due to the presence of the pharmacist in the exam room, a small cohort due to the COVID-19 pandemic, and investigator intervention identification